Lub Peb Hlis 24, 2026 yog hnub ua kev zoo siab rau hnub 31st World Tuberculosis Day. Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb (WHO) tau tshaj tawm lub ntsiab lus thoob ntiaj teb xyoo no ua"Yog lawm! Peb muaj peev xwm tshem tawm tus kab mob TB!", hais tias kev coj noj coj ua ntawm tsoomfwv muaj zog, kev cog lus ua nom ua tswv tas mus li, thiab kev sib koom tes ua haujlwm ntawm ntau lub koom haum yog qhov tseem ceeb rau kev xaus kev sib kis kab mob ntsws (TB).
Kev nce qib thoob ntiaj teb thiab cov teeb meem uas tseem tshuav
Raws li Daim Ntawv Qhia Txog Kab Mob Ntsws Thoob Ntiaj Teb Xyoo 2025, kev tswj kab mob ntsws thoob ntiaj teb tau ua tiav ib qho tseem ceeb hauv xyoo 2024, nrog rau ob qho tib si ikev sib kis thiab kev tuag poob qisthawj zaug txij li thaum muaj tus kab mob COVID-19 kis thoob plaws.
Kwv yees li10.7 lab tus tib neegtau tsim tus kab mob TB hauv xyoo 2024, suav nrog 54% txiv neej, 35% poj niam, thiab 11% menyuam yaus thiab cov hluas. Ntawm cov rooj plaub no, kwv yees li619,000 (5.8%)tau kis tus kab mob HIV ua ke, thiab390,000 (3.6%)cov kab mob TB uas tiv taus ntau yam tshuaj lossis tiv taus rifampicin (MDR/RR-TB).
TB ua rau kwv yees liMuaj 1.23 lab tus neeg tuagxyoo 2024, tseem yog tus kab mob sib kis ua rau neeg tuag coob tshaj plaws thoob ntiaj teb, dhau COVID-19. Tom qab peb xyoos ntawm kev nce ntxiv ntawm xyoo 2021 thiab 2023, kev kis tus kab mob TB thoob ntiaj teb tau poob qis yuav luag 2% hauv xyoo 2024, uas qhia txog kev rov zoo ntawm cov kev pabcuam TB. [1]
Nyob rau hauv thaj chaw,67% ntawm cov rooj plaubtau sib sau ua ke hauv yim lub tebchaws: Is Nrias teb, Indonesia, Philippines, Tuam Tshoj, Pakistan, Nigeria, Democratic Republic of the Congo, thiab Bangladesh.
Txawm hais tias muaj kev vam meej los xij, TB tseem yog ib qho ua rau cov neeg uas muaj tus kab mob HIV tuag coob tshaj plaws thiab yog ib qho ua rau cov neeg tuag coob tshaj plaws uas muaj feem cuam tshuam nrog kev tiv thaiv kab mob. Kev pab nyiaj txiag thoob ntiaj teb tseem tsis txaus, tsuas yogTebchaws Asmeskas $5.9 billionmuaj nyob rau hauv 2024 - qis dua qhovLub hom phiaj txhua xyoo ntawm US $ 22 billionteem rau xyoo 2027.
Cov lej no qhia txog qhov xav tau ceev ceev los txhawb cov kev pab cuam tswj kab mob TB thoob ntiaj teb, nrog rau kev tsom mus rau kev nthuav dav kev nkag mus rau kev kuaj mob, txhim kho cov txiaj ntsig kev kho mob, thiab daws cov teeb meem kev sib raug zoo uas ua rau kis kab mob TB. TB tseem xav tau kev koom tes thoob ntiaj teb thiab kev cog lus nom tswv kom ua tiav cov hom phiaj ntawm Txoj Kev Npaj Kawg TB
Mycobacterium tuberculosis: Pathogenesis thiab Classification
Mycobacterium tuberculosis (MTB/M. tuberculosis) yog tus kab mob tseem ceeb thiab feem ntau yog tus ua rau mob ntsws (TB). Nws tuaj yeem nkag mus rau hauv tib neeg lub cev los ntawm txoj hlab pa, txoj hnyuv zom zaub mov, lossis daim tawv nqaij thiab cov ntaub so ntswg uas puas lawm, kis rau ntau yam kabmob thiab ua rau muaj ntau hom mob ntsws. Mob ntsws, feem ntau kis tau los ntawm cov tee dej, suav txog ntau dua 80% ntawm cov neeg mob ntsws. Cov tsos mob feem ntau suav nrog hnoos, tso zis tawm, thiab ua pa tsis taus. Tom qab kis kab mob hauv lub ntsws, cov kab mob yuav kis mus rau hauv cov ntshav mus rau ntau lub cev, uas ua rau mob ntsws pob txha, tso zis, lossis mob ntsws.[2]
MTB yog ib feem ntawm genus Mycobacterium, uas suav nrog:
- Mycobacterium tuberculosis complex (MTBC): Muaj xws li M. tuberculosis, M. bovis, M. africanum, M. canettii, thiab M. microti, thiab lwm yam. Txawm hais tias M. tuberculosis yog tus kab mob tseem ceeb uas ua rau mob TB, M. bovis thiab M. africanum kuj tuaj yeem ua rau mob.
- Cov kab mob mycobacteria uas tsis yog tuberculous (NTM).
- Mycobacterium leprae, tus ua rau mob ruas.
Cov Kev Tshawb Fawb Hauv Chaw Kuaj Mob
Kev kuaj mob kom raug thiab raws sijhawm yog qhov tseem ceeb rau kev tswj tus kab mob TB kom zoo. Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb hais tiasCov thev naus laus zis kuaj mob sai sai tau hloov pauv qhov kev kuaj mob TB los ntawm kev ua kom muaj kev nkag siab zoo thiab tshwj xeeb ntawm cov kab mob thaum tib lub sijhawm kuaj pom kev tiv thaiv tshuaj[1].
- Microscopy thiab Culture: Kev kuaj kab mob tseem yog tus qauv kub rau kev kuaj mob TB, vim nws tso cai rau kev txheeb xyuas cov kab mob uas muaj sia nyob thiab txhawb kev kuaj mob thiab kev tshuaj ntsuam genomic. Txawm li cas los xij, vim yog Mycobacterium tuberculosis loj hlob qeeb, cov txiaj ntsig feem ntau yuav siv sijhawm 2-8 lub lis piam, txwv nws cov txiaj ntsig kho mob hauv kev txiav txim siab ceev.
-Kev Kuaj Mob Tiv Thaiv Kab Mob: Cov txheej txheem kev tiv thaiv kab mob, suav nrog kev kuaj mob ntsws (TST) thiab kev ntsuas kev tso tawm interferon-gamma (IGRAs), nrhiav pom cov lus teb ntawm tus tswv tsev lub cev tiv thaiv kab mob rau kev kis tus kab mob ntsws. Txawm hais tias muaj txiaj ntsig zoo rau kev txheeb xyuas tus kab mob latent, cov kev ntsuas no tsis tuaj yeem paub qhov txawv ntawm tus kab mob nquag thiab tus kab mob ua ntej thiab yog li ntawd muaj kev kuaj mob tsawg hauv cov chaw muaj teeb meem ntau.
-Kev Tshuaj Xyuas Molecular (NAAT): Kev kuaj DNA xws li nucleic acid amplification (NAAT) raug pom zoo rau lawv qhov kev rhiab heev thiab qhov tshwj xeeb.
-Kev Tshawb Fawb Txog Tiam Tom Ntej (tNGS): Cov thev naus laus zis tsom mus rau kev txheeb xyuas cov kev hloov pauv uas cuam tshuam nrog kev tiv thaiv muab kev daws teeb meem siab ntawm kev txheeb xyuas cov kev hloov pauv cuam tshuam nrog kev tiv thaiv. WHO cov lus qhia pom zoo tNGS ua ib qho cuab yeej siab heev rau kev kuaj pom kev tiv thaiv tshuaj tom qab kuaj mob, txhawb nqa cov tswv yim kho mob kom raug [3].
-Kev Tshawb Fawb Txog Tiam Tom Ntej ntawm Metagenomic (mNGS): Kev siv txoj kev tshawb nrhiav kab mob metagenomic ua rau muaj kev tshawb pom ntau yam kab mob yam tsis tas yuav xaiv lub hom phiaj ua ntej. Txoj hauv kev no muaj txiaj ntsig zoo rau cov xwm txheej nyuaj lossis tsis meej, suav nrog kev kis kab mob sib xyaw thiab cov neeg mob uas lub cev tiv thaiv kab mob tsis zoo, qhov twg kev kuaj mob ib txwm yuav tsis txaus.
WHO tseem hais ntxiv tias kev paub txog kab mob me me yog qhov tseem ceeb rau kev pib kho mob kom zoo thiab txhim kho cov txiaj ntsig ntawm tus neeg mob, ua kom pom tseeb qhov tseem ceeb ntawm kev koom ua ke cov kev kuaj mob molecular siab heev rau hauv cov kev pab cuam tswj kab mob TB [1].
Kev daws teeb meem Molecular Diagnostic uas muaj txhij txhua yam los ntawm Macro & Micro-Test
1.Kev Tshawb Nrhiav Multiplex PCR rau Kab Mob TB thiab Kev Tiv Thaiv TshuajTB
| Cov Cai Khoom | Lub Npe Khoom | Daim Ntawv Pov Thawj |
| HWTS-RT001 | Mycobacterium Tuberculosis DNA Detection Kit (Fluorescence PCR) | CE |
| HWTS-RT137 | Cov Khoom Siv Tshawb Nrhiav Kev Hloov Pauv ntawm Mycobacterium Tuberculosis Isoniazid (Kab Melting) | CE |
| HWTS-RT074 | Cov Khoom Siv Tshawb Nrhiav Kev Tiv Thaiv Mycobacterium Tuberculosis Nucleic Acid thiab Rifampicin (Kab Melting) | CE |
| HWTS-RT102 | Cov Khoom Siv Tshawb Nrhiav Nucleic Acid raws li Enzymatic Probe Isothermal Amplification (EPIA) rau Mycobacterium tuberculosis | CE |
| HWTS-RT144 | Cov Khoom Siv Kuaj Mob Mycobacterium Tuberculosis Complex Nucleic Acid Detection Kit (Enzymatic Probe Isothermal Amplification) uas tau muab ziab thiab khov (Freeze-dried) | CE |
| HWTS-RT105 | Cov Khoom Siv Kuaj DNA Mycobacterium Tuberculosis uas khov thiab qhuav (Fluorescence PCR) | CE |
| HWTS-RT147 | Mycobacterium Tuberculosis Nucleic Acid thiab Rifampicin, Isoniazid Resistance Detection Kit (Melting Curve) | CE |
Thaum muaj kev xav tias muaj kab mob ntsws (TB), tus kws kho mob yuav tsum kuaj xyuas seb puas muaj kab mob ntsws (TB) zoo.HWTS-RT147kev kuaj no raug pom zoo rau kev kuaj pom zoo ntawm kev kis tus kab mob MTB thiab kev tiv thaiv kab mob ntsws ntau yam (MDR-TB). Kev kuaj no txheeb xyuas cov kev hloov pauv hauvrpoB gene, uas ua rau muaj kev tiv thaiv rifampicin (RIF), thiab kev hloov pauv hauvCov noob caj noob ces katG thiab InhA, uas cuam tshuam nrog kev tiv thaiv isoniazid (INH). Nws muab kev sim zoo, ib zaug rau ob qho tib si MTB thiab MDR-TB, suav nrog kev tswj xyuas zoo sab hauv kom txo qis cov txiaj ntsig tsis tseeb, kom ntseeg tau tias cov txiaj ntsig sai thiab raug.
2.PTNseq Targeted Sequencing rau Cov Kab Mob Ua Pa thiab Kev Tiv Thaiv Profiling
| Cov Cai Khoom | Lub Npe Khoom | Cov Lus Qhia Tshwj Xeeb |
| HWKF-TS0001 | PTNseq Cov Khoom Siv Txhawb Nqa Cov Kab Mob Pathogen Gene Infection hauv Cov Ntshav | 24 qhov kev sim/pawg khoom siv |
| HWKF-TS0002 | PTNseq Cov Khoom Siv Txhim Kho Gene ntawm Cov Kab Mob Pathogenic Microorganism ntawm Lub Nruab Nrab Nervous System | 24 qhov kev sim/pawg khoom siv |
| HWKF-TS0003 | PTNseq Cov Khoom Siv Txhawb Nqa Cov Kab Mob Ua Pa Pathogen Gene | 24 qhov kev sim/pawg khoom siv |
| HWKF-AT0003 | PTNseq Kev Kab Mob Ua Pa Pathogenic Microorganisms Automated Enrichment Library Construction Kit (ONT) | 24 qhov kev sim/pawg khoom siv |
| HWKF-TS0004 | PTNseq Broad-Spectrum Infectious Pathogens Gene Enrichment Kit | 24 qhov kev sim/pawg khoom siv |
| HWKF-TS0005 | PTNseq Ultra-Broad-Spectrum Infectious Pathogenic Microorganism Gene Enrichment Kit | 24 qhov kev sim/pawg khoom siv |
| HWKF-TS0151 | Cov Khoom Siv Txhim Kho Gene ntawm Mycobacterium Typing thiab Drug Resistance (Txoj Kev Ua Kom Loj Hlob Ntau) | 24 qhov kev sim/pawg khoom siv |
Thaum muaj cov kab mob sib xyaw ua ke ntawm txoj hlab pa (xws li cov kab mob sab saud thiab sab qis ntawm txoj hlab pa, mob ntsws (tuberculosis), thiab cov kab mob ua pa ntev), lossis thaum xav tau kev tshuaj xyuas cov noob caj noob ces uas tiv taus tshuaj (piv txwv li, xav tias mob ntsws uas tiv taus tshuaj),PTNseq series ntawm kev nrhiav pom cov noob caj noob ces uas muaj txiaj ntsig zoosiv tau. Raws li thev naus laus zis targeted sequencing siab heev, PTNseq siv ultra-multiplex PCR los txhim kho cov kab ke tshwj xeeb, ua ke nrog high-throughput sequencing thiab thev naus laus zis nanopore tiam thib peb rau kev txheeb xyuas cov kab mob thiab kev tshuaj ntsuam xyuas kev tiv thaiv tshuaj.
Lub kaw lus siv cov primers uas tau txais patented, high-specificity rau kev ua kom cov noob caj noob ces loj hlob ntau heev. Txhawb nqa los ntawm lub database proprietary thiab cov algorithms bioinformatics ntse, nws muab kev txheeb xyuas cov kab mob kom raug nrog rau kev tiv thaiv tshuaj thiab kev tshuaj xyuas cov noob caj noob ces virulence. Kev nplua nuj tsom mus rau qhov chaw txo qhov cuam tshuam los ntawm tus tswv tsev DNA, txhim kho kev nkag siab hauv cov qauv uas muaj keeb kwm yav dhau los ntawm tib neeg thiab ua kom pom tau zoo ntawm cov hom phiaj nyuaj xws liKab mob Mycobacterium tuberculosis, cov kab mob fungi, cov kab mob intracellular, RNA viruses, thiab cov noob tiv taus lossis virulence.
PTNseq ua tiav qhov txwv ntawm kev ntes tautsawg li 100 daim / mLthiab npog175 hom kab mob ua pa uas feem ntau pom muaj, suav nrog 76 hom kab mob me me, 73 hom kab mob me me, 19 hom kab mob fungi, 7 hom kab mob mycoplasmas, thiabKab mob Chlamydia, Rickettsia, thiab 54 cov noob tiv thaiv tshuajLub vaj huam sib luag suav nrogKab mob Mycobacterium tuberculosiscov kab mob mycobacteria loj thiab nyuaj uas tsis yog tuberculous.
Cov koob PTNseq muab kev nkag siab zoo nrog kev siv nyiaj tsim nyog, txhim kho cov kab mob kom pom tseeb thiab txhawb nqa kev kho mob tua kab mob rau tus kheej thaum pab txo qhov kev tiv thaiv kab mob. Kev koom ua ke nrog lub tshuab npaj cov noob caj noob ces (AIOS) uas ua haujlwm tau zoo, nws muab kev daws teeb meem hauv tsev kho mob uas yooj yim thiab ua tiav sai li 6.5 teev txij li thaum kuaj mus txog qhov tshwm sim.
3. Kev Tshawb Fawb Txog Metagenomic rau Kev Tshawb Pom Kab Mob Dav Dav
| Cov Cai Khoom | Lub Npe Khoom | Cov Lus Qhia Tshwj Xeeb |
| HWKF-MN0011 | Cov Khoom Siv Tshawb Nrhiav Kab Mob Metagenomic (DNA-Illumina) | 24 qhov kev sim/pawg khoom siv |
| HWKF-MN0018 | Cov Khoom Siv Tshawb Nrhiav Kab Mob Metagenomic (DNA-MGI) | 24 qhov kev sim/pawg khoom siv |
| HWKF-MN0021 | Cov Khoom Siv Tshawb Nrhiav Kab Mob Metagenomic (DNA-ONT) | 24 qhov kev sim/pawg khoom siv |
| HWKF-MN0012 | Cov Khoom Siv Tshawb Nrhiav Kab Mob Metagenomic (RNA-Illumina) | 24 qhov kev sim/pawg khoom siv |
| HWKF-MN0019 | Cov Khoom Siv Tshawb Nrhiav Kab Mob Metagenomic (RNA-MGI) | 24 qhov kev sim/pawg khoom siv |
| HWKF-MN0022 | Cov Khoom Siv Tshawb Nrhiav Kab Mob Metagenomic (RNA-ONT) | 24 qhov kev sim/pawg khoom siv |
| HWKF-MN0013 | Cov Khoom Siv Tshawb Nrhiav Kab Mob Metagenomic (DNA + RNA-Illumina) | 24 qhov kev sim/pawg khoom siv |
| HWKF-AYM0013 | Kev Tshawb Nrhiav Kab Mob Metagenomic Automated Library Construction KiT (DNA + RNA-Illumina) | 24 qhov kev sim/pawg khoom siv |
| HWKF-MN0020 | Cov Khoom Siv Tshawb Nrhiav Kab Mob Metagenomic (DNA + RNA-MGI) | 24 qhov kev sim/pawg khoom siv |
| HWKF-MN0023 | Cov Khoom Siv Tshawb Nrhiav Kab Mob Metagenomic (DNA + RNA-ONT) | 24 qhov kev sim/pawg khoom siv |
Thaum kev kuaj mob tsis meej,Kev kuaj pom cov noob caj noob ces ntawm cov kab mob mNGS uas muaj txiaj ntsig zootuaj yeem ua tau rau ntau yam qauv los ntawm tus neeg mob, suav nrog cov kua dej ntxuav bronchoalveolar, hnoos qeev, cov ntaub so caj pas, ntshav, pleural effusion, kua qaub, thiab cov qauv ntaub so ntswg. Txoj hauv kev no siv cov thev naus laus zis metagenomic sequencing, qhov twg cov qauv sib txawv raug kho ua ntej ua raws li kev rho tawm nucleic acid siv cov hlaws iav thiab cov enzymes zom phab ntsa, txhim kho kev ua haujlwm rho tawm. Sequencing tau hloov kho rau ntau lub platform, kom ntseeg tau tias muaj cov ntaub ntawv ntau rau kev txhim kho mNGS rhiab heev thiab kev sib dhos ua ke. Cov ntaub ntawv raug tshuaj xyuas siv cov ntaub ntawv tus kheej tsim thiab cov algorithms ntse los ntesntau tshaj 20,000 tus kab mob sib kis, suav nrog cov kab mob bacteria, fungi, viruses, thiab parasites, muab cov ntaub ntawv ntawm cov kab mob pathogenic microorganisms. Txoj kev no yog tsim rau cov neeg mob uas nyuaj rau kuaj mob, mob hnyav, lossis cov neeg mob uas tsis muaj zog tiv thaiv kab mob, suav nrog kev txheeb xyuas covMTBnyuajthiabNTM, nrog rau kev sib kis kab mob sib xyaw. Nws txhim kho qhov nrawm ntawm kev kuaj pom kab mob thiab pab coj kev siv tshuaj tua kab mob rau lub hom phiaj kho mob, ua rau kev kuaj mob kab mob tau meej.
Xaus lus
Txawm hais tias muaj kev vam meej ntau heev los, kab mob ntsws tseem yog ib qho teeb meem loj hauv ntiaj teb kev noj qab haus huv, tshwj xeeb tshaj yog nyob rau hauv cov ntsiab lus ntawm kev tiv thaiv tshuaj, kev tsis muaj nyiaj txiag, thiab kev nkag mus rau kev kuaj mob tsis sib xws.
WHO hais tias kev nthuav dav kev nkag mus rau kev kuaj mob molecular sai thiab cov thev naus laus zis siab heev yog qhov tseem ceeb rau kev ua tiav lub hom phiaj ntawm Txoj Kev Npaj Kom Tsis Txhob Muaj Kab Mob TB. Nrog kev tsim kho tshiab, kev nqis peev, thiab kev koom tes thoob ntiaj teb, kev tshem tawm kab mob TB tsis yog ib qho kev cia siab lawm, tab sis yog lub hom phiaj uas ua tau.
Cov ntaub ntawv siv los ua piv txwv:
- Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb. Daim Ntawv Qhia Txog Kab Mob Ntsws Thoob Ntiaj Teb Xyoo 2024/2025: Kev Kuaj Mob thiab Kev Kho Mob.
- Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb. Phau Ntawv Qhia Txog Kev Xaiv Cov Kev Ntsuas Sai Sai Uas WHO Pom Zoo Rau Kev Tshawb Pom Kab Mob Ntsws thiab Kab Mob Ntsws Uas Tiv Thaiv Tshuaj.
- Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb. WHO Cov Lus Qhia Txog Kab Mob Ntsws: Module 3 - Kev Kuaj Mob (Xyoo 2024 Hloov Kho Tshiab).
Lub sijhawm tshaj tawm: Lub Peb Hlis-24-2026