Kumbondera chirwere (muChingezi: diagnosis) mumutauro wevanoita nezveutano zvinoreva gwara rinotungamirira pakuzoziva kuti ndechipi chirwere kana chimiro chiri kukonzera zviratidzo zveurwere pamunhu. Kazhinji-zhinji kacho izvi zvinodaidzwa nezita rekuti kumbondera zvakarerekera kunezveutano. Humwe humbowo hunodikanwa pakumbondera chirwere hunounganidzwa kubva munhoroondo yemurwere nekumuongorora muviri wake. Kazhinji, kunotevedzwa danho rimwe kana maviri ekumbondera chirwere, akaita sekuvhenekwa nanachiremba. Dzimwe nguva kunyangwe kumbondera pamunhu atofa kunotorwa senzira yekumbondera zviri pamurawo wezveutano. Kumbondera chirwere kazhinji kunogozha, nokuti zviratidzo zvizhinji hazvina chirwere chimwe chazvakarerekera kwachiri. Semuenzaniso, kutsvukuruka kweganda kunogona kuva mucherechedzo wezvimiro zvakaipa zvakawanda, nokudaro hakugoni kutaridza mushandi wezveutano pane dambudziko.

Gwara chinjirudza

Zvikamu zvinowanzowanikwa mugwara rekumbondera chirwere muruzhinji rwenzira dziripo dzekuita izvi dzinosanganisira:

  • Kuwedzera kutsvagurudza umbowo pamuroro pevarwere, zvinogona izvo kusanganisira mibvunzo yenhoroondo yezveutano hwemurwere (kunyanya kubva kune vamwe vanhu vari pedyo nemurwere), kuongorora muviri wemurwere wacho pamwe nekuita vheneko yakanangana nekumbondera.
  • Vheneko yakanangana nekumbondera chirwere zvinoreva rudzi rwupi kana rwupi rwevheneko inoitwa navana chiremba kuitira kubatsira pakumbondera kana kudondana nechirwere. Vheneko yakanangana nekumbondera chirwere inogona zvakare kushandiswa kupa humbowo hweramangwana rechirwere pavanhu vakatobatwa kare nechirwere chacho.[1]
  • Kunzvera mhinduro nezvinenge zvabuda mutsvagurudzo. Kunogonawo kuitwa hurukuro nekubvunzira kune vamwewo vanoita basa rimwe chetero nenyanzvi mubazi iroro.

Kune nzira nezvidobi dzakawanda zvinogona kushandiswa mugwara rekumbondera chirwere, kusanganisira kumbondera kunobudisa musiyano pakati pechirwere nezvimwe zvirwere zvine zviratidzo zvakafanana nacho kana kuita wongororo inoshandisa mishina yema kombiyuta inodaidzwa pachirungu kuti "medical algorithms".[2] Chokwadi ndechekuti gwara rekumbondera chirwere rinosanganisira zvidimbu zvidimbu zvenzira dzakasiyana-siyana.[3]

Kumbondera chirwere che Dzihwamupengo (Khovhidhi-19) chinjirudza

 
Kutaridzika kwechimedu chekuongorora chirwere che COVID-19.

Kubatwa kwemunhu nechirwere cheKhovhidhi-19 kunogona kufanombonderwa nekutarisa zviratidzo zvechirwere kunyangwe hazvo izvi zvichifanira kuzotsinhirwa neinonzi pachirungu "reverse transcription polymerase chain reaction (rRT-PCR)" yetsvina dzemuviri wemurwere wacho kana kuti ne mishina inoongorora mukati memuviri, kana kuti nechirungu CT imaging.[4][5] Tsvagurudzo yakaitwa yekuenzanisa PCR ne CT muguta reWuhan inoratidza kuti CT inoratidza zviri nane pane PCR, kunyangwe zvayo isinganyatsodondanisa, zviratidzo zvizhinji zvayo zvichinopindirana nezvezvimwe zvirwere zvemabayo. Kusvika mumwedzi waKurume 2020, veAmerican College of Radiology vanokurudzira kuti "CT haifaniri kushandiswa senzira yekutanga yekunzvera nekumbondera chirwere che Khovhidhi-19".[6]

Kuwongorora hutachiwana/Kuongorwa kwehutachiona chinjirudza

Sangano reWHO rakabudisa zvinyorwa zvakawanda zvemirairo yekushandisa "RNA testing" pakumbondera chirwere che Khovhidhi-19, chekutanga chacho chichibuda musi wa 17 ndira.[7] [8] [9] Nzira iyi yekunzvera inoshandisa "reverse transcription polymerase chain reaction (rRT-PCR)" yechiriporipo.[10] Kunzvera uku kunogona zvakare kuitwa paropa kana pamamte anenge atorwa pamurwere kuti anowongororwa.[11] Zvinobuda muwongororo iyi kazhinji zvinowanikwa mukati memaawa mashoma kana mazuva.[12][13] Kazhinji wongororo iyi iyi inoitwa pachikarahwa chinotorwa kumasure kwehuro kubudikidza nemumhino, kunyangwe hazvo dzimwe nguva pachishandiswa chinotorwa kumashure kwehuro kubudikidza nemukanwa.[14]

Nzvimbo zhinji dzekuwongororwa kwehutachiwana kanakuti marabhoritari nemamwe makambani, ari kuita wongororo yeropa iyo inokwanisa kuona nekuwana masoja emuviri kana kuti nechirungu ma antibodies.[15] Kusvika musi wa16 Kubvumbi 2020, hapana imwe yenzira idzi yati yabudirira zvakakwana zvekuti ingagamuchirwa kuti ichishandiswa kwese-kwese.[16] Munyika yeAmerika wongororo inotsvaga chirwere nekuwongorora ropa iyo yakagadzirwa nekambani yeCellex yakabvumidzwa kushandiswa nemarabhoritari ane zvitupa chete.[17]

Mifananidzo chinjirudza

 
Mufananidzo werudzi rwe CT scan yechifuva chemunhu ane hutachiwana hwe Khovhidhi-19. Unoratidza zvimanyerekete/zvimavara zvakacheneruka pamapapu.

Mifananidzo yakatorwa nemishina, yerudzi rwe radiograph ne CT yevanhu vane zviratidzo zvechirwere inosanganisira zvinodaidzwa nechirungu kuti "asymmetric peripheral ground glass opacities and absent pleural effusions."[18] Sangano re italian Radiological Society riri mushishi kubatanidza dura reruzivo richakwanisa kuwanikwa nenyika dzose padandemutande rinoratidza mifananidzo yezviwanikwa zvakabuda pakuongororwa kwevanhu vakatotsinhirwa kuti zvirokwazvo vane hutachiwana hwe Khovhidhi-19.[19] Nokuda kwekuti zvimwe zvirwere zvakaita se adenovirus zvinogona kubudisa mifananidzo yakafanana, mifananidzo isina kutsinhirwa nePCR hainyatsogamuchiriki semucherechedzo we Khovhidhi-19.[18] Wongororo huru yakaitwa munyika ye Chayina iyo yaienzanisa mifananidzo yechifuva ye CT neyePCR yakaratidza kutikunyangwe hako kutorwa kwemifananidzo kusinganyatsodondana nehutachiwana , nzira iyi inokasira zvakare inobudisa zvechokwadi, zvichireva kuti yakakodzera kutorwa seimw enzira yekuwongorora chirwere munzvimbo dzachinenge chapararia kusvika padanho rekuva "epidemic".[5] Kune purogiramu dzezvemishina yemakombiyuta dzakagadzirwa dzinokwanisa kuona zvimiro zvemufananidzo wehutachiwana dzichishandisa zvose mishina yema xray neye CT.[20]

Mabviro eruzivo chinjirudza

  1. Thompson, C. & Dowding, C. (2009) Essential Decision Making and Clinical Judgement for Nurses.
  2. "Making a diagnosis", John P. Langlois, Chapter 10 in Fundamentals of clinical practice (2002). Mark B. Mengel, Warren Lee Holleman, Scott A. Fields. 2nd edition. p. 198. ISBN 0-306-46692-9
  3. "Making a diagnosis", John P. Langlois, Chapter 10 in Fundamentals of clinical practice (2002). Mark B. Mengel, Warren Lee Holleman, Scott A. Fields. 2nd edition. p. 204. ISBN 0-306-46692-9
  4. "CT provides best diagnosis for COVID-19". ScienceDaily. Retrieved 14 March2020.
  5. 5.0 5.1 Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. (February 2020). "Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases". Radiology: 200642. doi:10.1148/radiol.2020200642. PMID 32101510.
  6. "ACR Recommendations for the use of Chest Radiography and Computed Tomography (CT) for Suspected COVID-19 Infection". American College of Radiology. 22 March 2020.
  7. Laboratory testing of 2019 novel coronavirus (2019-nCoV) in suspected human cases: interim guidance, 17 January 2020 (PDF) (Report). World Health Organization. 17 January 2020. hdl:10665/330676. ISBN 9789240000971.
  8. Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases: interim guidance, 2 March 2020 (PDF) (Report). World Health Organization. 2 March 2020. hdl:10665/331329. WHO/COVID-19/laboratory/2020.4.
  9. "Coronavirus disease (COVID-19) technical guidance: Laboratory testing for 2019-nCoV in humans". World Health Organization. Archived from the original on 15 March 2020. Retrieved 14 March 2020.
  10. "Coronavirus Disease 2019 (COVID-19) Situation Summary". US Centers for Disease Control and Prevention. 30 January 2020. Archived from the original on 26 January 2020. Retrieved 30 January 2020.
  11. "Real-Time RT-PCR Panel for Detection 2019-Novel Coronavirus". U.S. Centers for Disease Control and Prevention (CDC). 29 January 2020. Archived from the original on 30 January 2020. Retrieved 1 February 2020.
  12. Brueck H (30 January 2020). "There's only one way to know if you have the coronavirus, and it involves machines full of spit and mucus". Business Insider. Archived from the original on 1 February 2020. Retrieved 1 February 2020.
  13. "Curetis Group Company Ares Genetics and BGI Group Collaborate to Offer Next-Generation Sequencing and PCR-based Coronavirus (2019-nCoV) Testing in Europe". GlobeNewswire. 30 January 2020. Archived from the original on 31 January 2020. Retrieved 1 February 2020.
  14. "Coronavirus Disease 2019 (COVID-19)". Centers for Disease Control and Prevention. 11 February 2020. Retrieved 5 April 2020.
  15. Vogel G (19 March 2020). "New blood tests for antibodies could show true scale of coronavirus pandemic". Science | AAAS. Retrieved 6 April 2020.
  16. "Coronavirus antibody tests: How they work and when we'll have them". BBC Science Focus Magazine. Retrieved 6 April 2020.
  17. Azad A. "FDA authorizes first coronavirus antibody test". CNN. Retrieved 6 April2020.
  18. 18.0 18.1 Li Y, Xia L (March 2020). "Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management". AJR. American Journal of Roentgenology: 1–7. doi:10.2214/AJR.20.22954. PMID 32130038.
  19. "COVID-19 DATABASE | SIRM" (in Italian). Retrieved 11 March 2020.
  20. Li L, Qin L, Xu Z, Yin Y, Wang X, Kong B, et al. (March 2020). "Artificial Intelligence Distinguishes COVID-19 from Community Acquired Pneumonia on Chest CT". Radiology: 200905. doi:10.1148/radiol.2020200905. PMID 32191588.