Yini Umgomo we-Bacillus of Calmette and Guerin (BCG): Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

Umgomo we-Bacillus of Calmette and Guerin (BCG) ngumgomo obukhoma, obuthakathaka wamagciwane osiza ukuvikela ngokuphambana nomdlavuza wamaphaphu (TB). Lo mgomo usetshenziswe ngokuphepha cishe iminyaka eyikhulu futhi uqukethe uhlobo oluguquliwe lwamagciwane ahlobene ne-TB angeke abangele lesi sifo sangempela kodwa aqeqeshe amasosha akho omzimba ukuthi akwazi ukuqaphela futhi alwe nawo.

Umgomo we-BCG unikezwa njengomjovo owodwa ngaphansi kwesikhumba, ngokuvamile engalweni engenhla. Ngenkathi ingasetshenziswa njalo e-United States, iyithuluzi elibalulekile lezempilo yomphakathi emazweni amaningi lapho i-TB ivamile khona.

Yini Umgomo we-BCG?

Umgomo we-BCG wenziwe ngohlobo olubukhoma kodwa olubuthakathaka lwamagciwane okuthiwa i-Mycobacterium bovis. Ososayensi baseFrance u-Albert Calmette noCamille Guérin bathuthukisa lo mgomo ekuqaleni kwawo-1900 ngokubuthakathisa ngokucophelela amagciwane iminyaka eminingi baze bakwazi ukuvuselela ukuzivikela ngaphandle kokubangela isifo.

Cabanga ngakho njengokuzivocavoca kwamasosha akho omzimba. Uma uthola umgomo, umzimba wakho ufunda ukuqaphela nokukhumbula amagciwane e-TB, ngakho-ke uma uke wavezwa entweni yangempela, amasosha akho omzimba angaphendula ngokushesha nangempumelelo.

Umgomo ubhekwa njengo

Umjovo usebenza kahle kakhulu uma unikezwa izinsana nezingane ezincane. Awusebenzi kangako ekuvikeleni uhlobo lwe-TB oluthinta amaphaphu kubantu abadala, yingakho imigomo yokugoma ihluka kakhulu phakathi kwamazwe ngokusekelwe emazingeni abo e-TB.

Isebenza Kanjani Umjovo we-BCG?

Umjovo we-BCG uthathwa njengomjovo osebenza kahle ngokulinganisela osebenza ngokuqeqesha amasosha akho omzimba ukuthi aqaphele amagciwane e-TB. Lapho amagciwane abuthakathaka engena emzimbeni wakho, amaseli akho omzimba ayawofunda futhi akhe inkumbulo yokuthi i-TB ibukeka kanjani.

Amasosha akho omzimba abese ekhiqiza ama-antibody futhi asebenzise amaseli akhethekile omzimba abizwa ngokuthi ama-T-cells angaphendula ngokushesha uma uveza amagciwane e-TB ngemuva kwesikhathi esithile. Le nkumbulo yamasosha omzimba ingahlala iminyaka eminingi, nakuba ingase ibe buthaka ngokuhamba kwesikhathi.

Umjovo usebenza kahle kakhulu ekuvikeleni izinhlobo ezinzima, ezisongela impilo ze-TB, ikakhulukazi ezinganeni. Unikeza ukuvikeleka okungaba ngu-70-80% ngokumelene ne-TB meningitis kanye ne-TB esabalalisiwe, kodwa ukuvikeleka okungaba ngu-50% kuphela ngokumelene ne-pulmonary (amaphaphu) TB kubantu abadala.

Kufanele Ngiwuthathaphi Umjovo we-BCG?

Umjovo we-BCG unikezwa njengomjovo owodwa ngaphansi nje kwesikhumba (i-intradermal injection) engalweni engenhla. Umhlinzeki wokunakekelwa kwezempilo uzosebenzisa inaliti ekhethekile ukubeka umjovo phakathi kwezingqimba zesikhumba sakho, hhayi ngaphakathi emsipheni.

Akudingeki wenze lutho olukhethekile ukulungiselela umjovo. Ungadla ngokujwayelekile ngaphambi nangemva komjovo, futhi akudingeki ukuthi uwuthathe nokudla noma amanzi ngoba akuyona imithi yomlomo.

Indawo yokujova kufanele igcinwe ihlanzekile futhi yomile. Ungafaki noma yimaphi ama-creams, ama-ointments, noma amabhandishi endaweni ngaphandle uma umhlinzeki wakho wokunakekelwa kwezempilo ekuncoma ngqo. Indawo yokujova cishe izokwakha iqhubu elincane futhi ingase yakhe iqweqwe emasontweni alandelayo.

Kufanele Ngiwuthathe Isikhathi Esingakanani Umjovo we-BCG?

Umjovo we-BCG ngokuvamile unikezwa njengomthamo owodwa, ngokuvamile esemncane noma ebusheni. Ngokungafani neminye imijovo edinga imithamo eminingi noma ama-booster, abantu abaningi badinga umjovo owodwa kuphela we-BCG empilweni yabo.

Ukuvikeleka emjovweni we-BCG kungahlala iminyaka engu-10-20, nakuba lokhu kuhluka kumuntu nomuntu. Ezimweni eziningi, imijovo ye-booster ayinconyelwe noma ayidingekile emphakathini jikelele.

Nokho, uma usebenzisa i-BCG njengendlela yokwelapha umdlavuza wesinye, ungase udinge imithamo eminingi enikezwa ngqo esinyeni emasontweni amaningana noma izinyanga. Udokotela wakho we-oncologist uzokwenza isimiso esithile sokwelashwa esisekelwe esimweni sakho.

Yiziphi Izimo Ezingezinhle Zomjovo we-BCG?

Abantu abaningi baba nezimo ezingezinhle ezincane ezivela emjovweni we-BCG ezivamile ngokuphelele futhi zibonisa ukuthi amasosha akho omzimba ayasabela. Ukusabela okuvame kakhulu kusendaweni yokujova, lapho cishe uzobona izinguquko emasontweni ambalwa alandelayo.

Nakhu ongakulindela njengokuphendula okuvamile endaweni yokujova:

• Ibhampa elincane elibomvu elivela phakathi kwamasonto angu-2-6
• Ibhampa lingase likhule futhi ngezinye izikhathi lithuthuke libe yisilonda esincane, esingashoni
• I-scab ingase yakheke futhi ekugcineni iwe, ishiye isibazi esincane
• Oketshezi oluthile olucacile noma olungcolile lungase luphume endaweni
• Ukuthambisa okuncane noma ubuhlungu engalweni

Lezi zimo zendawo empeleni ziyizimpawu zokuthi umjovo uyasebenza futhi umzimba wakho wakha ukuzivikela. Inqubo yokuphulukisa ingathatha izinyanga ezingu-2-6 ukuze iqede.

Izimo ezingezinhle ezingavamile kodwa ezisavame zihlanganisa:

• Ama-lymph nodes avuvukile ekhwapheni ngasohlangothini olufanayo nomjovo
• Umkhuhlane omncane (ngokuvamile olinganiselwe)
• Ukukhathala okujwayelekile noma ukuzizwa ungaphilile usuku olulodwa noma ezimbili

Lezi zimpawu ngokuvamile zizixazulula zodwa futhi azidingi ukwelashwa.

Izimo ezingezinhle ezingathi sína azivamile kodwa zingenzeka. Xhumana nomhlinzeki wakho wezempilo uma uhlangabezana:

• Umkhuhlane omkhulu (ongaphezu kuka-101°F noma 38.3°C) ohlala izinsuku ezingaphezu kwezi-2-3
• Ukuvuvukala okukhulu noma ubuhlungu endaweni yokujova
• Izimpawu zokutheleleka njengemigqa ebomvu evela endaweni yokujova
• Isilonda esikhulu noma esiqhubekayo endaweni yokujova (ngaphezu kuka-1 cm)
• Amanodi e-lymph avuvukele abe makhulu kakhulu noma abuhlungu

Izinkinga ezingavamile kakhulu zihlanganisa ukutheleleka okusabalalele kwe-BCG, okungenzeka kubantu abanezinhlelo zokuzivikela ezibuthakathaka kakhulu. Yingakho umgomo unganikezwa kubantu abanezifo ezithile zohlelo lokuzivikela.

Ubani Ongafanele Athole Umgomo we-BCG?

Umgomo we-BCG awuphephile kuwo wonke umuntu, ikakhulukazi labo abanezinhlelo zokuzivikela ezibuthakathaka. Njengoba iqukethe amagciwane aphilayo, ingase ibangele izifo ezinzima kubantu abangakwazi ukulwa ngisho namagciwane abuthakathaka.

Akufanele uthole umgomo we-BCG uma une:

• Ukutheleleka nge-HIV noma i-AIDS
• Umdlavuza othinta uhlelo lokuzivikela (njenge-leukemia noma i-lymphoma)
• Izifo zokungasebenzi kahle kwe-immunodeficiency
• Uthatha imithi ecindezela uhlelo lokuzivikela (njengama-steroid adosi ephezulu noma i-chemotherapy)
• Uke wathola ukufakelwa kwesitho
• Uthola i-radiation therapy

Umgomo awunconyelwe futhi:

• Abesifazane abakhulelwe (nakuba ngokuvamile kuphephile ngenkathi bencelisa)
• Abantu abanokutheleleka okusebenzayo kwe-TB
• Labo abanezifo ezinzima ezingamahlalakhona noma umkhuhlane
• Noma ubani onesimo sesikhumba esibi endaweni yokujova
• Abantu abake baba nokusabela okukhulu komzimba emgomweni we-BCG wangaphambilini

Ngaphezu kwalokho, izinsana ezizalwe omama abane-HIV akufanele zithole umgomo we-BCG kuze kube yilapho isimo sabo se-HIV sesinqunyiwe, njengoba kungenzeka ukuthi zizuze izinkinga zohlelo lokuzivikela.

Amagama Omkhiqizo Womgomo we-BCG

Umjovo we-BCG uyatholakala ngaphansi kwamagama amaningi emhlabeni wonke, nakuba ukutholakala kuhluka ngamazwe. E-United States, uma isetshenziselwa ukwelashwa komdlavuza wesinye, ivame ukwaziwa ngamagama emikhiqizo afana ne-TICE BCG noma i-TheraCys.

Abakhiqizi abahlukene bangase bakhiqize izinhlobo ezihlukene kancane zebhaktheriya le-BCG, kodwa zonke zisebenza ngendlela efanayo. Umhlinzeki wakho wezempilo uzosebenzisa noma iyiphi inguqulo etholakalayo futhi efanele isimo sakho esithile.

Uma uhamba phesheya futhi udinga amarekhodi okugoma, qiniseka ukuthi uqaphela ukuthi yimuphi umjovo we-BCG owutholile, njengoba amanye amazwe angase abe nezintandokazi zezinhlobo ezithile noma abakhiqizi.

Ezinye izindlela zokugoma ze-BCG

Njengamanje, azikho ezinye izindlela ezitholakala kabanzi zokugoma ze-BCG zokuvimbela isifo sofuba. Ngenkathi abacwaningi besebenza ekuthuthukiseni imithi emisha ye-TB, i-BCG isahlala iyona kuphela umuthi wokugoma onelayisense wokuvimbela i-TB emhlabeni wonke.

Kubantu abangakwazi ukuthola umuthi wokugoma we-BCG ngenxa yezinkinga zesistimu yokuzivikela komzimba, ukuvimbela kugxila ekugwemeni ukuchayeka ku-TB nokuthola ukuhlolwa njalo. Lokhu kungase kuhlanganise ukuthatha ama-antibiotics okuvimbela uma uchayeke kumuntu one-TB esebenzayo.

Mayelana nokwelashwa komdlavuza wesinye, ezinye izindlela ze-BCG zihlanganisa ezinye izindlela zokwelapha ngomzimba, imithi ye-chemotherapy efakwa ngqo esinyeni, noma izinqubo zokuhlinzwa. Udokotela wakho we-oncologist angaxoxa ngalezi zinketho uma i-BCG ingakulungele.

Ingabe umuthi wokugoma we-BCG ungcono kunezinye izindlela zokuvimbela i-TB?

Umjovo we-BCG njengamanje uyithuluzi elingcono kakhulu elitholakalayo lokuvimbela izinhlobo ezinzima zesifo sofuba ezinganeni, kodwa akuphelele. Isebenza kahle kakhulu uma ihlanganiswe namanye amaqhinga okuvimbela i-TB kunokuba isetshenziswe yodwa.

Uma kuqhathaniswa nokungagonywa, i-BCG inciphisa kakhulu ingozi ye-TB meningitis kanye ne-TB esabalalisayo ezinganeni. Kodwa-ke, inikeza ukuvikeleka okuncane ku-TB yamaphaphu, ikakhulukazi kubantu abadala, yingakho amazwe amaningi anamazinga aphansi e-TB engayifaki ezinhlelweni zawo zokugoma ezivamile.

Ukuvimbela i-TB okuphumelela kakhulu kuhlanganisa ukugonywa kwe-BCG (lapho kufanele khona) nemikhuba emihle yokulawula ukutheleleka, ukutholwa kwangaphambi kwesikhathi nokwelashwa kwamacala e-TB asebenzayo, kanye nokwelashwa okuvikelayo kubantu abasengozini enkulu yokuthuthukisa i-TB.

Imibuzo Evame Ukubuzwa Mayelana Nomgomo we-BCG

Ingabe Umgomo we-BCG Uphephile Kubantu Abanesifo Sikashukela?

Umgomo we-BCG ngokuvamile uphephile kubantu abanesifo sikashukela, uma nje isifo sabo sikashukela silawulwa kahle futhi bengenazo ezinye izinkinga zesimiso somzimba sokuzivikela. Isifo sikashukela ngokwaso ngokuvamile asibuthisi isimiso somzimba sokuzivikela ngokwanele ukwenza ukugonywa kwe-BCG kube yingozi.

Kodwa-ke, abantu abanesifo sikashukela bangase babe nengozi ephakeme kancane yokuthuthukisa izifo, ngakho-ke kubalulekile ukuqapha indawo yokujova ngokucophelela ukuze kutholakale izimpawu zokuphola okungavamile noma ukutheleleka. Umhlinzeki wakho wezempilo angase afune ukulandela eduze ukuze aqinisekise ukuthi indawo yokugoma iyaphola kahle.

Ngingenzani uma ngithola umgomo we-BCG omningi ngengozi?

Akunakwenzeka ukuthi uthole umgomo we-BCG omningi ngengozi ngoba unikezwa njengomthamo owodwa, olinganiswe ngokucophelela ngumhlinzeki wezempilo. Umgomo uza ngamabhodlela alinganiselwe ngaphambili, futhi abahlinzeki bezempilo baqeqeshwa ekulinganiseni okufanele.

Uma ukhathazekile ngokuthola umthamo ongafanele, xhumana nomhlinzeki wakho wezempilo ngokushesha. Bangahlola isimo sakho futhi bakuqaphe nganoma yiziphi izindlela ezingavamile, nakuba izinkinga ezingathi sína ezivela emaphutheni okulinganisa zingavamile kakhulu.

Ngingenzani uma ngiphuthelwa umgomo we-BCG ohleliwe?

Njengoba i-BCG ivamise ukunikezwa njengomthamo owodwa, ngokuvamile akukho simo "somthamo olahlekile" njengemithi oyithatha njalo. Uma uphuthelwe ukuqokwa komgomo we-BCG okuhleliwe, vele uhlele kabusha nomhlinzeki wakho wezempilo ngokushesha okukhulu.

Ezinsaneni nasezinganeni, i-BCG isebenza kahle kakhulu uma inikezwa ekuqaleni kwempilo, ngakho-ke ungalibali isikhathi eside ekuhleleni kabusha. Kodwa-ke, umgomo usengaba usizo ngisho noma unikezwe kamuva kunalokho okwakuhleliwe.

Ngingayeka nini ukukhathazeka ngemiphumela emibi yomgomo we-BCG?

Imiphumela eminingi emibi yomgomo we-BCG yenzeka phakathi namasonto ambalwa okuqala kuya ezinyangeni ngemuva kokugonywa. Ukusabela kwendawo yokujova kuvamise ukuqala emasontweni angu-2-6 ngemuva kokugonywa futhi kungaqhubeka izinyanga ezingu-2-6 njengoba umzimba wakho wakha ukuzivikela emzimbeni.

Uma indawo yokujova iselapheke ngokuphelele futhi noma iyiphi ama-lymph node avuvukile abuyele osayizini yawo ejwayelekile, ngokuvamile ungaqeda ukuqapha imiphumela emibi ehlobene nomgomo. Lokhu kuvame ukwenzeka kungakapheli izinyanga eziyisi-6 zokugonywa.

Ngingathola yini ukuhlolwa kwesikhumba se-Tuberculosis ngemuva kokugonywa kwe-BCG?

Umgomo we-BCG ungathinta imiphumela yokuhlolwa kwesikhumba se-tuberculosis, okungenzeka kubangele imiphumela engamanga emihle iminyaka eminingi ngemuva kokugonywa. Lokhu kungenxa yokuthi amasosha akho omzimba angase asabele ekuhlolweni kwesikhumba ngisho noma ungenayo i-TB esebenzayo.

Uma uke wagonywa nge-BCG, umhlinzeki wakho wezempilo angase akhethe ukusebenzisa ukuhlolwa kwegazi okubizwa ngokuthi i-interferon-gamma release assays (IGRAs) ukuhlola ukutheleleka nge-TB, njengoba lokhu kuhlolwa kungenakwenzeka ukuthi kuthintwe ukugonywa kwe-BCG. Njalo yazisa umhlinzeki wakho wezempilo nganoma yikuphi ukugonywa kwe-BCG kwangaphambilini lapho uhlolwa i-TB.