Ikingo rya Bacillus ya Calmette na Guérin (BCG): Ibikoresho, Urutonde rw'imiti, Ingaruka ziterwa n'ibindi

Ikingo rya Bacillus ya Calmette na Guérin (BCG) ni urukingo rukoresha mikorobe zikiriho, zoroheje zifasha kurwanya igituntu (TB). Uru rukingo rwakoreshejwe mu buryo bwizewe hafi ikinyejana kandi rukubiyemo uburyo bwahinduwe bwa mikorobe ifitanye isano na TB idashobora gutera indwara nyayo ariko yatoza umubiri wawe kwibuka no kuyirwanya.

Urukingo rwa BCG rutangwa nk'urushinge rumwe munsi y'uruhu, akenshi mu kaboko k'igice cyo hejuru. Nubwo itajya ikoreshwa muri Leta Zunze Ubumwe z'Amerika, ni igikoresho cy'ingenzi mu buzima rusange mu bihugu byinshi aho TB ikunze kugaragara.

Ikingo rya BCG ni iki?

Urukingo rwa BCG rukorwa muri mikorobe ikiriho ariko yorohejwe yitwa Mycobacterium bovis. Abahanga b'Abafaransa Albert Calmette na Camille Guérin bakoze uru rukingo mu ntangiriro za 1900 binyuze mu kunaniza mikorobe neza mu myaka myinshi kugeza igihe yashoboye gutera ubudahangarwa itateje indwara.

Tekereza nk'imyitozo yo gutoza umubiri wawe. Iyo wakiriye urukingo, umubiri wawe wigira kumenya no kwibuka mikorobe ya TB, bityo niba wigeze guhura n'ikintu nyacyo, umubiri wawe urwanya indwara ushobora gusubiza vuba kandi neza.

Urukingo rufatwa nk'urukingo

Urukingo rukora neza iyo rutanzwe ku bana bato n'abana. Ntirusa neza mu gukumira indwara ya TB yo mu bihaha ku bantu bakuru, ni yo mpamvu politiki zo gukingira zitandukanye cyane hagati y'ibihugu bitewe n'uko indwara ya TB ikwirakwira.

Urukingo rwa BCG rukora gute?

Urukingo rwa BCG rufatwa nk'urukingo rukora neza ku rugero ruciriritse rukora mu kwigisha umubiri wawe kwakira mikorobe ya TB. Iyo mikorobe yoroshye yinjira mu mubiri wawe, imikorere y'umubiri wawe irayiga kandi ikarema urwibutso rw'uko TB isa.

Umubiri wawe ukora imisemburo y'abarwanya indwara hanyuma ugakoresha uturemangingo twihariye tw'umubiri twitwa T-cells dushobora gusubiza vuba niba wahuye na mikorobe ya TB nyayo nyuma. Uru rwibutso rw'umubiri rushobora kumara imyaka myinshi, nubwo rushobora kugabanuka uko igihe gishize.

Urukingo rukora neza cyane mu gukumira ubwoko bukomeye bw'indwara ya TB butera ubuzima kwangirika, cyane cyane ku bana. Rutanga uburinzi bugera kuri 70-80% ku ndwara ya TB yo mu bwonko na TB ikwirakwira, ariko rutanga uburinzi bugera kuri 50% gusa ku ndwara ya TB yo mu bihaha (mu bihaha) ku bantu bakuru.

Nkwiriye gufata urukingo rwa BCG nte?

Urukingo rwa BCG rutangwa nk'urushinge rumwe munsi y'uruhu (urushinge rwa intradermal) mu kaboko ka ruguru. Umuganga azakoresha urushinge rwihariye kugirango ashyire urukingo hagati y'imyanya y'uruhu rwawe, atari kure mu misitsi.

Nta kintu na kimwe ugomba gukora kugirango witegure urukingo. Urashobora kurya uko bisanzwe mbere na nyuma yo guterwa urushinge, kandi ntugomba kurufata hamwe n'ibiryo cyangwa amazi kuko atari umuti unyobwa.

Aho urushinge rwashyizweho rugomba kugumishwa isuku kandi humye. Ntukoreshe amavuta, imiti, cyangwa bandeji kuri ako gace keretse niba umuganga wawe abikugiriyeho inama by'umwihariko. Aho urushinge rwashyizweho birashoboka ko hazagaragara agahinda gato kandi gashobora gukora igishishwa mu byumweru bikurikira.

Nkwiriye gufata urukingo rwa BCG igihe kingana iki?

Urukinga rwa BCG akenshi rutangwa nk'urukingo rumwe, akenshi mu bwana cyangwa mu bwana bwo hambere. Bitandukanye n'inkingo zimwe na zimwe zisaba inkingo nyinshi cyangwa izongera imbaraga, abantu benshi bakeneye urukingo rumwe rwa BCG mu buzima bwabo.

Uburinzi butangwa n'urukingo rwa BCG bushobora kumara imyaka 10-20, nubwo ibi bitandukana ku muntu ku muntu. Mu bihe byinshi, inkingo zongera imbaraga ntizisabwa cyangwa ntizikenewe ku baturage muri rusange.

Ariko, niba ukoresha BCG nk'umuti wo kuvura kanseri y'umuyoboro w'inkari, ushobora gukenera inkingo nyinshi zitangwa mu buryo butaziguye mu muyoboro w'inkari mu gihe cy'ibyumweru byinshi cyangwa amezi. Umuganga wawe w'indwara z'umubiri azakora gahunda yihariye yo kuvura ishingiye ku miterere yawe bwite.

Ni izihe ngaruka ziterwa n'urukingo rwa BCG?

Abantu benshi bahura n'ingaruka nto ziterwa n'urukingo rwa BCG zisanzwe rwose kandi zerekana ko umubiri wawe urimo gusubiza. Igisubizo gikunze kubaho ni ahantu urukingo rwatangiwe, aho ushobora kubona impinduka mu byumweru bike biri imbere.

Ibi nibyo ushobora kwitega nk'ibisanzwe ahantu urukingo rwatangiwe:

• Agahinda gato gatukura kagaragara mu byumweru 2-6
• Agahinda gashobora kwiyongera kandi rimwe na rimwe kakavamo igisebe gito, kidakomeye
• Uruhu rushobora gukora hanyuma rugakurwaho, rugasiga inkovu nto
• Amazi amwe asobanutse cyangwa afite urujijo ashobora kuva ahantu
• Urubavu ruto cyangwa kubabara mu kuboko

Ibi bisubizo byaho ni ibimenyetso byerekana ko urukingo rukora kandi umubiri wawe urimo kubaka ubudahangarwa. Uburyo bwo gukira bushobora gufata amezi 2-6 kugirango burangire.

Ingaruka zitabaho cyane ariko zigisanzwe zirimo:

• Imitsi yabyimbye mu kwaha ku ruhande rumwe n'urukingo
• Urubavu ruto (akenshi ruri hasi)
• Kunanirwa muri rusange cyangwa kumva utameze neza umunsi umwe cyangwa ibiri

Ibi bimenyetso akenshi bikira byonyine kandi ntibisaba kuvurwa.

Ingaruka zikomeye ni gake ariko zirashobora kubaho. Vugana n'umuganga wawe niba uhuye na:

• Urusazi rwinshi (rurenze 101°F cyangwa 38.3°C) rumara iminsi irenga 2-3
• Ukubura gukabije cyangwa kubabara ahaterwa urukingo
• Ibimenyetso byo kwandura nko gushushanya gutukura kuva aho urukingo rwatangiwe
• Icyuronda kinini cyangwa gikomeye ahaterwa urukingo (kinini kuri cm 1)
• Imitsi yabyimbye iba minini cyane cyangwa ibabaza

Ingorane zitabaho cyane zirimo kwandura BCG byagutse, bishobora kubaho ku bantu bafite uburwayi bw'umubiri bukomeye. Ibi nibyo bituma urukingo rutangwa ku bantu bafite uburwayi bumwe na bumwe bw'umubiri.

Ninde utagomba guhabwa urukingo rwa BCG?

Urukingo rwa BCG ntirugenewe buri wese, cyane cyane abafite uburwayi bw'umubiri. Kubera ko ikubiyemo mikorobe nzima, ishobora gutera indwara zikomeye ku bantu batabasha kurwanya mikorobe nkeya.

Ntabwo ugomba guhabwa urukingo rwa BCG niba ufite:

• Uburwayi bwa HIV cyangwa SIDA
• Ubukana bugira ingaruka ku mikorere y'umubiri (nka leukemia cyangwa lymphoma)
• Uburwayi bw'ibanze bwo kudakomera kw'umubiri
• Uri gufata imiti igabanya imikorere y'umubiri (nka steroid nyinshi cyangwa imiti ivura kanseri)
• Wagize igihe cyo kwimura urugingo
• Uri guhabwa imirasire

Urukingo ntirukunzwe kandi kuri:

• Abagore batwite (nubwo muri rusange ari amahoro mugihe cyo konsa)
• Abantu banduye TB ikora
• Abafite uburwayi bukomeye cyangwa umuriro
• Umuntu wese ufite uburwayi bukomeye bw'uruhu ahaterwa urukingo
• Abantu bagize allergie ikomeye ku rukingo rwa BCG rwari rwaratanzwe mbere

Byongeye kandi, abana bavukiye ku babyeyi banduye HIV ntibagomba guhabwa urukingo rwa BCG kugeza igihe icyo aricyo cyose cy'uburwayi bwabo bwa HIV kizwi, kuko bashobora kuba barazwe ibibazo by'imikorere y'umubiri.

Amazina y'ubwoko bw'urukingo rwa BCG

Urukingo rwa BCG ruboneka mu mazina menshi y'ubucuruzi ku isi hose, nubwo kuboneka bitandukanye bitewe n'igihugu. Muri Leta Zunze Ubumwe z'Amerika, iyo rukoreshwa mu kuvura kanseri y'inkari, akenshi ruzwi n'amazina y'ubucuruzi nka TICE BCG cyangwa TheraCys.

Abakora imiti batandukanye bashobora gukora ubwoko butandukanye gato bwa bagiteri ya BCG, ariko zose zikora mu buryo bumwe. Umuganga wawe azakoresha urwo ruriho kandi rukwiye kubera imiterere yawe yihariye.

Niba urimo kujya mu mahanga kandi ukeneye inyandiko z'inkingo, menya neza kwandika urukingo rwa BCG wahawe, kuko ibihugu bimwe bishobora gukunda ubwoko runaka cyangwa abakora imiti.

Izindi nkingo zisimbura BCG

Kugeza ubu, nta zindi nkingo zisimbura urukingo rwa BCG rwo gukumira igituntu ziboneka cyane. Nubwo abashakashatsi bari gukora ku iterambere ry'inkingo nshya za TB, BCG iracyakomeza kuba urukingo rukoreshwa rukemewe rwo gukumira TB ku isi hose.

Ku bantu batabasha guhabwa urukingo rwa BCG kubera ibibazo by'ubudahangarwa, gukumira byibanda ku kwirinda guhura na TB no gupimwa buri gihe. Ibi bishobora gukubiyemo gufata imiti ikingira niba warahuye n'umuntu ufite TB ikora.

Mugushaka kuvura kanseri y'inkari, ibindi bisimbura BCG birimo izindi immunotherapies, imiti ya chemotherapy ishyirwa mu nkari, cyangwa ibikorwa byo kubaga. Umuganga wawe w'indwara z'umwijima ashobora kuganira kuri izi nzira niba BCG itagukwiriye.

Ese urukingo rwa BCG ruruta izindi nzira zo gukumira TB?

Urukingo rwa BCG ubu ni igikoresho cyiza cyane gihari cyo gukumira ubwoko bukomeye bwa igituntu mu bana, ariko ntirutunganye. Bikora neza cyane iyo byegeranijwe n'izindi nzira zo gukumira TB aho gukoreshwa wenyine.

Ugereranije no kutagira urukingo, BCG igabanya cyane ibyago byo kurwara meningite ya TB na TB ikwirakwira mu bana. Ariko, itanga uburinzi buke ku bijyanye na TB yo mu bihaha, cyane cyane mu bantu bakuru, ni yo mpamvu ibihugu byinshi bifite umubare muto wa TB bitayishyira muri gahunda zabo zisanzwe zo gukingira.

Uburyo bwiza bwo gukumira TB buhuriza hamwe urukingo rwa BCG (aho bikwiye) hamwe n'imyitwarire myiza yo kugenzura ikwirakwira ry'indwara, kumenya no kuvura kare abarwayi ba TB, no kuvura abantu bari mu kaga ko kurwara TB.

Ibibazo Bikunze Kubazwa ku Rukingo rwa BCG

Ese Urukingo rwa BCG Rufite Umutekano ku Barwayi ba Diyabete?

Urukingo rwa BCG muri rusange rufite umutekano ku barwayi ba diyabete, igihe cyose diyabete yabo igenzurwa neza kandi badafite izindi ngorane z'ubudahangarwa. Diyabete ubwayo ntisanzwe iteza intege nke ubudahangarwa ku buryo bwo gutuma urukingo rwa BCG rugira akaga.

Ariko, abantu barwaye diyabete bashobora kugira ibyago byinshi byo kurwara indwara, bityo ni ngombwa gukurikirana ahantu batera urukingo neza kugira ngo bamenye ibimenyetso byo gukira bidasanzwe cyangwa indwara. Umuganga wawe ashobora gushaka gukurikirana hafi kugira ngo yemeze ko ahantu batera urukingo hakira neza.

Nkwiriye gukora iki niba mbonye urukingo rwa BCG rwinshi ku buryo butunganye?

Biragoye cyane kubona urukingo rwa BCG rwinshi ku buryo butunganye kuko rutangwa nk'urukingo rumwe, rupimwa neza na muganga. Urukingo ruzanwa mu mpapuro zapimwe mbere, kandi abaganga baba baratojwe gupima neza.

Niba ufite impungenge zo kubona urukingo rutari rwo, vugana n'umuganga wawe ako kanya. Bashobora gusuzuma uko ubuzima bwawe buhagaze kandi bakagukurikiranira ibimenyetso byose bidasanzwe, nubwo ibibazo bikomeye biturutse ku makosa yo gupima bidakunze kubaho.

Nkwiriye gukora iki niba ntasibye urukingo rwa BCG rwatanzwe?

Kubera ko BCG isanzwe itangwa nk'urukingo rumwe, akenshi ntihabaho ikibazo cyo "kutabona urukingo" nk'uko bimeze ku miti ufata buri gihe. Niba waraburiwe umwanya wo guhabwa urukingo rwa BCG, ongera uteganye n'umuganga wawe vuba bishoboka.

Ku bana bato n'abana, BCG ikora neza cyane iyo itanzwe hakiri kare mu buzima, bityo ntutinde cyane mu kongera guteganya. Ariko, urukingo ruracyakora nubwo rwatanzwe nyuma y'uko byari biteganyijwe.

Ni ryari nshobora kureka guhangayika ku ngaruka ziterwa n'urukingo rwa BCG?

Inyinshi mu ngaruka ziterwa n'urukingo rwa BCG zigaragara mu byumweru bike cyangwa amezi make nyuma yo gukingirwa. Ibyagaragariye aho batera urukingo bisanzwe bitangira nyuma y'ibyumweru 2-6 nyuma yo gukingirwa kandi bishobora gukomeza mu mezi 2-6 mu gihe umubiri wawe wubaka ubudahangarwa.

Iyo aho batera urukingo hakize neza kandi imitsi yabyimbye yagarutse mu busanzwe, muri rusange urashobora kureka gukurikirana ingaruka ziterwa n'urukingo. Ibi bikunda kuba mu mezi 6 nyuma yo gukingirwa.

Nshobora gukorerwa isuzuma ry'uruhu rwa tuberculosis nyuma yo gukingirwa BCG?

Urukingo rwa BCG rushobora kugira ingaruka ku bisubizo by'isuzuma ry'uruhu rwa tuberculosis, rushobora gutera ibisubizo by'ibinyoma byiza mu myaka myinshi nyuma yo gukingirwa. Ibi biterwa n'uko umubiri wawe w'ubudahangarwa ushobora gusubiza ku isuzuma ry'uruhu nubwo udafite TB ikora.

Niba warakingiwe BCG, umuganga wawe ashobora guhitamo gukoresha ibizamini by'amaraso byitwa interferon-gamma release assays (IGRAs) kugira ngo barebe niba hari indwara ya TB, kuko ibi bizamini ntibishobora kugirwaho ingaruka n'urukingo rwa BCG. Buri gihe menyesha umuganga wawe ku byerekeye urukingo rwa BCG rwo hambere igihe uri gupimwa indwara ya TB.