Bayanin gabaɗaya
Tarin fuka (tuberculosis/TB) cuta ce da ƙwayar Mycobacterium tuberculosis ke haifarwa. Ta fi shafar huhu amma tana iya shafar kowane sashe na jiki.
Alamomi
Alamomi | Yawan faruwa | Tsanani | Farawa |
|---|---|---|---|
| Tari | 95% | Matsakaici | Farkon cuta |
| Zazzabi | 60% | Dan kadan | Farkon cuta |
| Rashin son ci | 55% | Dan kadan | Farkon cuta |
| Gumi da dare | 70% | Dan kadan | Farkon cuta |
| Raguwar nauyi | 65% | Matsakaici | Farkon cuta |
| Sanyi | 30% | Dan kadan | Farkon cuta |
| Rashin jin daɗi | 60% | Dan kadan | Farkon cuta |
| Fitar da jini ta tari | 20% | Mai tsanani | Kololuwar cuta |
| Tari mai fitar da miyau | 80% | Matsakaici | Kololuwar cuta |
| Matsewar ƙirji | 40% | Matsakaici | Kololuwar cuta |
| Ƙarancin numfashi | 35% | Matsakaici | Kololuwar cuta |
| Bushewar numfashi | 15% | Dan kadan | Kololuwar cuta |
| Ciwon baya | 10% | Matsakaici | Ƙarshen cuta |
| Rikicewa | 3% | Mai tsanani | Ƙarshen cuta |
| Ciwon kai | 8% | Matsakaici | Ƙarshen cuta |
| Kumburin haɗin gaɓoɓi | 5% | Dan kadan | Ƙarshen cuta |
| Taurin wuya | 5% | Mai tsanani | Ƙarshen cuta |
| Duhuwar fitsari | 3% | Dan kadan | Ƙarshen cuta |
| Gajiya | 75% | Dan kadan | Kowane lokaci |
| Kumburin ƙwayoyin lymph | 25% | Dan kadan | Kowane lokaci |
| Ciwon ciki | 8% | Dan kadan | Kowane lokaci |
Hanyoyin yaduwa
Bayanin gabaɗaya
Cutar da ke yaɗuwa wacce ke shafar huhu musamman, da Mycobacterium tuberculosis ke haifarwa.
Bayanin gabaɗaya
Tarin fuka (Tuberculosis — TB) cutar kwayoyin cuta ce da Mycobacterium tuberculosis (bacillus na Koch) ke haddasa ta. Ita ce cutar da ta fi kashe mutane daga kwayar cuta daya a duniya (mutuwar miliyan 1.25/shekara). Najeriya tana cikin kasashe 30 masu mafi girman nauyin TB a duniya — WHO ta kiyasta fiye da shari'o'i 440,000 na sabbin kamuwa a Najeriya a shekara. Hadin cutar TB da HIV yana da matukar hatsari — Najeriya tana da daya daga cikin mafi yawan TB/HIV co-infection a duniya. TB mai juriya ga magungunan farko (MDR-TB) yana karuwa. Allurar BCG a haihuwa tana cikin jadawalin NPHCDA. Cuta ce da dole a bayar da rahotonta.
Alamomin gaggawa
Tofa jini (haemoptysis). Tari ≥mako 3 + zazzabin maraice + raguwar nauyi. Ciwon kai mai ci gaba + alamun sankarau (TB meningitis). Wahalar numfashi mai tsanani.
Cikakkun alamomi
Alamomi da alamu mafi yawa
TB na huhu: tari ≥mako 3 (babbar alamar farko), tofa jini (haemoptysis), zazzabin maraice, gumi na dare, raguwar nauyi. TB na waje huhu: a membrane din huhu (pleural), a glandin lymph, a kasusuwa (Pott's disease), a kwakwalwa (TB meningitis), a ko'ina (miliary TB). A Najeriya: duk wanda yake da tari ≥mako 2 ya kamata a gwada shi don TB (NTBLCP protocol).
Sanin alamomi shine mataki na farko don amsa cikin sauri.
Tafiyar cuta
Matakan cutar tarin fuka:
- Kamuwa ta farko: Shaƙar ƙwayoyin cutar M. tuberculosis → ƙwayar cuta ta farko a huhu. Mafi yawan mutane (90%) suna hana ci gaban cutar → kamuwar tarin fuka mai ɓoyewa (LTBI). Babu alamomi, TST/IGRA tabbatacce.
- Tarin fuka mai ɓoyewa (watanni zuwa shekaru da yawa): Babu alamomi, ba mai yaɗuwa ba. Ƙwayoyin cuta suna barci a cikin granuloma.
- Sake kunna / tarin fuka mai aiki: Farawa a hankali cikin makonni zuwa watanni:
- Tari mai fitar da ƙura na dindindin (fiye da makonni 2–3), tarin jini (10–20%).
- Alamomin gabaɗaya: gumi na dare, zazzaɓi, raguwar nauyi, gajiya.
- Cutar huhu mai rami a saman huhu a hoton X-ray na ƙirji (alamar gargajiya).
- Ci gaban cuta (ba tare da magani ba): Rami a huhu, cutar ɓangarorin biyu na huhu, yaɗuwa ta cikin numfashi. Raguwar jiki ("cutar lalacewa"). Yaɗuwar miliary ko tarin fuka a waje da huhu (ƙwayoyin lymfa, huhu, ƙasusuwa, ƙwaƙwalwa, tsarin haihuwa) a cikin marasa ƙarfin rigakafi.
Yaɗuwa: Marasa lafiya masu tabbataccen gwajin ƙura sun fi yaɗa cutar. Ikon yaɗuwa ya ragu sosai cikin makonni 2 na ingantaccen magani.
Binciken cuta
Yadda ake gano wannan cutar
GeneXpert MTB/RIF — gwajin da ake amfani da shi sosai a Najeriya (yana gano TB da juriya ga rifampicin cikin sa'o'i 2). Smear microscopy (AFB). Culture. Chest X-ray. Tuberculin Skin Test (TST) ko IGRA (don latent TB). Najeriya ta samu GeneXpert machines a duk jihohi 36 + FCT ta hanyar NTBLCP da PEPFAR.
Magani
Hanyoyin magani da ake da su
Tsarin HRZE/HR: watanni 2 na HRZE (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol) + watanni 4 na HR (Isoniazid, Rifampicin). Directly Observed Therapy (DOT) — dole ne. MDR-TB: Bedaquiline, Linezolid, Levofloxacin (BPaL regimen). A Najeriya: NTBLCP (National TB and Leprosy Control Programme) yana ba da magani kyauta ta hanyar DOTS centres a ko'ina cikin kasa.
Yawancin lokuta ana magance su yadda ya kamata tare da gano cutar da wuri.
Cikakkun bayanin rigakafi
Yadda za ka kare kanka
BCG a haihuwa (jadawalin NPHCDA). Maganin latent TB infection (LTBI): Isoniazid watanni 6–9. Gano masu cutar da wuri da fara magani. A Najeriya: NTBLCP yana gudanar da active case finding musamman a tsakanin masu HIV, masu hulda da mai cutar TB, da kamammu.
Shirye-shirye shine mafi kyawun kariya.
Shawarar tafiya
Gwajin IGRA kafin da bayan tafiya mai tsawo (>watanni 3) zuwa Najeriya ko kasashen da suka fi fama da TB. Tari ≥mako 3 bayan tafiya: a gwada don TB. Ka guji cunkoson jama'a a wuraren da ba su da isasshen iska.
Yaya yawancinta?
Ƙididdiga da bayanan yanki
Najeriya: ta 6 a jerin kasashen da suka fi fama da TB a duniya. WHO ta kiyasta ~440,000 sabbin shari'o'i/shekara. Amma ana gano ~30–40% kawai (babban "gibi" — missing cases). TB/HIV: ~14% na masu TB a Najeriya suna da HIV. MDR-TB: ~4.3% na sabbin shari'o'i.
Dalilan haɗari
Wanene ke cikin haɗarin mafi girma
Tafiya zuwa ƙasashe masu yawan nauyi (Kudu maso Gabashin Asiya, Afirka ta Kudu da Sahara, Yammacin Tekun Pasifik), cutar HIV, maganin danne garkuwar jiki, kusanci da lokuta na TB mai aiki, ma'aikatan lafiya, mazauna wuraren tarawa (wuraren mafaka, gidajen yari), rashin abinci mai gina jiki, ciwon suga, shan taba, silikosis.
Cikakkun bayanan matsaloli
Rikitarwa da za ta iya faruwa
Lalacewar huhu na dindindin. Tofa jini mai tsanani. Cutar sauran gabobi (kasusuwa, kwakwalwa, koda). TB meningitis: mutuwa kashi 20–50%. MDR-TB: tsawon magani (watanni 9–20), kudin magani mafi girma. TB/HIV co-infection: hadari biyu suna ƙara hatsarin juna.
Murmurewa da hasashe
Sakamakon da ake tsammani da murmurewa
Tarin fuka mai ɓoyewa: Haɗarin sake kunna na 5–10% a cikin rayuwa ga mutane masu ƙarfin rigakafi. Magani da isoniazid (watanni 9) ko rifampin (watanni 4) yana rage haɗarin sake kunna da 60–90%.
Tarin fuka na huhu mai sauƙin magani:
-
Tare da maganin watanni 6 na yau da kullum (2HRZE/4HR): adadin warkarwa fiye da 95%.
-
Ba tare da magani ba: ~50% suna mutuwa cikin shekaru 5, ~25% suna warke da kansu, ~25% suna zama marasa lafiya na dindindin.
Tarin fuka mai juriyar magani:
-
MDR-TB (mai juriya ga isoniazid + rifampin): tsawon magani watanni 9–20, adadin warkarwa 50–75%.
-
XDR-TB: adadin warkarwa 30–50% tare da sabbin magunguna (bedaquiline, pretomanid, linezolid).
Tarin fuka a waje da huhu: Hasashen warkarwa ya danganta da wurin. Tarin fuka na ƙwaƙwalwa yana da mutuwa 20–30% da mummunar lalacewar jijiyoyi.
