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Abakozi bashinzwe ubuzima bakoze isuzuma rinini bakoresheje ibizamini bya antigen byihuse ku ishuri ry’Ubufaransa.Inguzanyo y'ishusho: Thomas Samson / AFP / Getty
Mu gihe umubare w'abantu banduye coronavirus mu Bwongereza wariyongereye mu ntangiriro za 2021, guverinoma yatangaje ko hashobora guhinduka umukino mu kurwanya COVID-19: miliyoni z’ibizamini bya virusi bihendutse kandi byihuse.Ku ya 10 Mutarama, yavuze ko izateza imbere ibi bizamini mu gihugu hose, ndetse no ku bantu badafite ibimenyetso.Ibizamini nkibi bizagira uruhare runini muri gahunda ya Perezida Joe Biden yo gukumira icyorezo gikabije muri Amerika.
Ibi bizamini byihuse mubisanzwe bivanga izuru cyangwa umuhogo hamwe namazi kumurongo wimpapuro kugirango ugarure ibisubizo mugihe cyisaha.Ibi bizamini bifatwa nkibizamini byanduye, ntabwo ari ibizamini byanduye.Bashobora gusa kumenya imitwaro myinshi ya virusi, bityo bazabura abantu benshi bafite virusi ya SARS-CoV-2.Ariko ikizere nuko bazafasha kwirinda icyorezo mukumenya vuba abantu banduye cyane, bitabaye ibyo bakwirakwiza virusi batabizi.
Icyakora, ubwo guverinoma yatangazaga gahunda, havutse impaka zirakaye.Bamwe mu bahanga bishimiye ingamba zo kwipimisha mu Bwongereza.Abandi bavuga ko ibi bizamini bizabura kwandura cyane ku buryo iyo bikwirakwijwe kuri miliyoni, ingaruka zishobora gutera ziruta ibyangiritse.Jon Deeks, inzobere mu gupima no gusuzuma muri kaminuza ya Birmingham mu Bwongereza, yizera ko abantu benshi bashobora koroherwa n'ibizamini bibi kandi bagahindura imyitwarire.Kandi, yavuze, niba abantu bayobora ibizamini ubwabo, aho kwishingikiriza ku banyamwuga bahuguwe, ibi bizamini bizabura izindi ndwara.We na mugenzi we wa Birmingham Jac Dinnes (Jac Dinnes) ni abahanga, kandi bizeye ko bakeneye amakuru menshi ku bizamini bya coronavirus byihuse mbere yuko bikoreshwa cyane.
Ariko abandi bashakashatsi ntibatinze kurwanya, bavuga ko ikizamini gishobora guteza ingaruka mbi kandi ko ari “inshingano” (reba go.nature.com/3bcyzfm).Muri bo harimo Michael Mina, inzobere mu byorezo mu ishuri ry’ubuzima rusange rya Harvard TH Chan i Boston, muri Massachusetts, wavuze ko iyi mpaka idindiza igisubizo gikenewe cyane kuri iki cyorezo.Yagize ati: “Turacyavuga ko tudafite amakuru ahagije, ariko turi hagati y'intambara ukurikije umubare w'imanza, mu byukuri ntituzaba mubi kurusha ikindi gihe cyose.”
Gusa icyo abahanga bemeranya nuko hagomba kubaho itumanaho risobanutse kubijyanye nikizamini cyihuse nicyo ibisubizo bibi bivuze.Mina yagize ati: “Gutera ibikoresho abantu batazi kubikoresha neza ni igitekerezo kibi.”
Biragoye kubona amakuru yizewe kubizamini byihuse, kuko-byibuze muburayi-ibicuruzwa bishobora kugurishwa gusa hashingiwe kumibare yabakozwe nta isuzuma ryigenga.Nta protocole isanzwe yo gupima imikorere, biragoye rero kugereranya ibizamini no guhatira buri gihugu gukora igenzura ryacyo.
Umuyobozi mukuru wa Innovative New Diagnostics Foundation (FIND), umuryango udaharanira inyungu i Geneve mu Busuwisi, wongeye gusuzuma no kugereranya uburyo bwinshi bwo gusesengura COVID -19, Catharina Boehme yagize ati: "Iyi ni ishyamba ry’iburengerazuba mu gusuzuma."
Muri Gashyantare 2020, FIND yatangiye umurimo ukomeye wo gusuzuma amagana ya COVID-19 y'ibizamini bisanzwe.Fondasiyo ikorana n’umuryango w’ubuzima ku isi (OMS) n’ibigo by’ubushakashatsi ku isi mu gupima amagana ya coronavirus no kugereranya imikorere yabo n’ibiboneka hakoreshejwe ikoranabuhanga ryoroshye rya polymerase (PCR).Ikoranabuhanga rishakisha uburyo bwihariye bwa virusi ikurikirana mu ngero zafashwe mu mazuru cyangwa mu muhogo (rimwe na rimwe amacandwe).Ibizamini bishingiye kuri PCR birashobora kwigana byinshi muribi bikoresho byifashishije inzinguzingo nyinshi za amplification, kugirango babashe kumenya umubare wambere wa parvovirus.Ariko birashobora gutwara igihe kandi bigasaba abakozi bahuguwe neza nibikoresho bya laboratoire bihenze (reba “Ukuntu COVID-19 ikora ibizamini”).
Ibizamini bihendutse, byihuse birashobora gukora mugushakisha poroteyine zihariye (hamwe bita antigene) hejuru ya SARS-CoV-2.Izi "test antigen yihuta" ntabwo yongerera ibikubiye muri sample, bityo virusi irashobora kumenyekana gusa mugihe virusi igeze murwego rwo hejuru mumubiri wumuntu-hashobora kuba kopi ibihumbi nibihumbi bya virusi kuri mililitiro yicyitegererezo.Iyo abantu banduye cyane, virusi ikunze kugera kuri izi nzego mugihe ibimenyetso byatangiye (reba “Fata COVID-19 ″).
Dinnes yavuze ko amakuru y’uruganda ku bijyanye no kwiyumvisha ibizamini aturuka ahanini mu bizamini bya laboratoire ku bantu bafite ibimenyetso bifite imitwaro myinshi ya virusi.Muri ibyo bigeragezo, ibizamini byinshi byihuse byasaga naho byoroshye..
Urwego rwa virusi murugero rusanzwe rugereranywa hifashishijwe umubare wa PCR amplification cycle ikenewe kugirango hamenyekane virusi.Mubisanzwe, niba bisabwa hafi ya PCR ya amplification ya PCR cyangwa munsi yayo 25 (byitwa inzitizi yumuzingi, cyangwa Ct, bingana cyangwa munsi ya 25), noneho urwego rwa virusi nzima rufatwa nkurwego rwo hejuru, byerekana ko abantu bashobora kwandura-nubwo bitaribyo birasobanutse niba abantu bafite cyangwa badafite urwego rukomeye rwo kwandura.
Mu Gushyingo umwaka ushize, guverinoma y'Ubwongereza yashyize ahagaragara ibyavuye mu bushakashatsi bwibanze bwakorewe muri Porton Down Science Park na kaminuza ya Oxford.Ibisubizo byose bitarasuzumwa n’urungano byashyizwe ahagaragara ku ya 15 Mutarama. Ibisubizo byerekana ko nubwo ibizamini byinshi byihuta bya antigen (cyangwa “urujya n'uruza”) “bitagera ku rwego rusabwa kugira ngo abaturage benshi boherezwe,” muri ibizamini bya laboratoire, ibirango 4 kugiti cye byari bifite agaciro ka Ct cyangwa munsi ya 25. FIND yongeye gusuzuma ibikoresho byinshi byipimisha byihuse mubisanzwe birerekana kandi ko ibyiyumvo byurwego rwa virusi ari 90% cyangwa birenga.
Mugihe urwego rwa virusi rugabanutse (nukuvuga agaciro ka Ct kuzamuka), ibizamini byihuse bitangira kubura kwandura.Abashakashatsi bo muri Porton Down bitaye cyane ku bizamini bya Innova Medical byabereye i Pasadena, muri Californiya;guverinoma y'Ubwongereza yakoresheje miliyoni zirenga 800 z'amapound (miliyari 1,1 $) kugira ngo itegeke ibyo bizamini, igice cy'ingenzi mu ngamba zayo zo kugabanya ikwirakwizwa rya coronavirus.Kurwego rwa Ct rwa 25-28, ibyiyumvo byikizamini bigabanuka kugera kuri 88%, naho kurwego rwa Ct rwa 28-31, ikizamini cyaragabanutse kugera kuri 76% (reba "Ikizamini cyihuse gisanga umutwaro mwinshi wa virusi").
Ibinyuranye, mu Kuboza, Parike ya Abbott, Illinois, Laboratoire ya Abbott yasuzumye ikizamini cyihuse cya BinaxNOW hamwe n'ibisubizo bibi.Ubushakashatsi bwagerageje abantu barenga 3.300 i San Francisco, muri Californiya, kandi bwabonye 100% ku byitegererezo bifite urugero rwa Ct munsi ya 30 (nubwo uwanduye atagaragaje ibimenyetso) 2.
Ariko, sisitemu zitandukanye za PCR zisobanura ko urwego rwa Ct rudashobora kugereranywa byoroshye hagati ya laboratoire, kandi ntabwo buri gihe byerekana ko urugero rwa virusi murugero ari rumwe.Innova yavuze ko ubushakashatsi bw’Ubwongereza na Amerika bwakoresheje sisitemu zitandukanye za PCR, kandi ko kugereranya mu buryo butaziguye kuri sisitemu imwe byagira akamaro.Berekanye raporo ya guverinoma y'Ubwongereza yanditswe n'abahanga ba Porton Down mu mpera z'Ukuboza ihuza ikizamini cya Innova n'ikizamini cya Abbott Panbio (bisa n'ibikoresho bya BinaxNOW byagurishijwe na Abbott muri Amerika).Mubitegererezo birenga 20 gusa hamwe nurwego rwa Ct munsi ya 27, ibyitegererezo byombi byagaruye ibisubizo byiza 93% (reba go.nature.com/3at82vm).
Iyo usuzumye ibizamini bya Innova ku bantu ibihumbi n'ibihumbi muri Liverpool, mu Bwongereza, impanvu zerekeranye na Calibibasi ya Ct zari ingenzi, zagaragaje gusa bibiri bya gatatu by'imanza zifite urwego rwa Ct ziri munsi ya 25 (reba go.nature.com) / 3tajhkw).Ibi birerekana ko ibizamini byabuze kimwe cya gatatu cyabantu bashobora kwandura.Icyakora, ubu byemezwa ko muri laboratoire itunganya ingero, agaciro ka Ct kangana na 25 kangana na virusi yo hasi cyane mu zindi laboratoire (wenda zingana na Ct ya 30 cyangwa irenga), nk'uko byatangajwe na Iain Buchan, umushakashatsi mu buzima na Informatics muri kaminuza y'Abanyamerika.Liverpool, yayoboye urubanza.
Ariko, ibisobanuro ntabwo bizwi neza.Dix yavuze ko ikigeragezo cyakozwe na kaminuza ya Birmingham mu Kuboza ari urugero rw'ukuntu ikizamini cyihuse cyabuze kwandura.Abanyeshuri barenga 7,000 badafite ibimenyetso byaho bakoze ikizamini cya Innova;2 gusa ni bo bapimwe ibyiza.Ariko, mugihe abashakashatsi ba kaminuza bakoresheje PCR kugirango basuzume 10% byintangarugero, basanze abandi banyeshuri batandatu banduye.Ukurikije igipimo cyintangarugero zose, ikizamini gishobora kuba cyarabuze abanyeshuri 60 banduye3.
Mina yavuze ko aba banyeshuri bafite virusi nkeya, bityo bakaba batandura mu buryo ubwo aribwo bwose.Dix yizera ko nubwo abantu bafite virusi nkeya ya virusi bashobora kuba bari mu bihe byanyuma byo kugabanuka kwanduye, bashobora no kuba banduye.Ikindi kintu nuko abanyeshuri bamwe batitwara neza mugukusanya icyitegererezo cya swab, ntabwo rero virusi nyinshi zishobora gutsinda ikizamini.Afite impungenge ko abantu bazibeshya ko gutsinda ikizamini kibi bishobora kurinda umutekano wabo-mubyukuri, ikizamini cyihuse ni ifoto gusa ishobora kutandura muri kiriya gihe.Deeks yavuze ko kuvuga ko kwipimisha bishobora gutuma akazi gakorwa neza atari bwo buryo bwiza bwo kumenyesha abaturage imikorere yacyo.Yavuze ati: “Niba abantu bumva nabi umutekano, barashobora gukwirakwiza iyi virusi.”
Ariko Mina n'abandi bavuze ko abapilote ba Liverpool bagiriye inama abantu kutabikora kandi babwiwe ko bashobora gukomeza gukwirakwiza virusi mu gihe kiri imbere.Mina yashimangiye ko gukoresha kenshi ibizamini (nk'inshuro ebyiri mu cyumweru) ari urufunguzo rwo gukora ibizamini neza kugira ngo birinde icyorezo.
Gusobanura ibisubizo by'ibizamini ntibiterwa gusa n'ukuri kw'ikizamini, ahubwo biterwa n'amahirwe yuko umuntu asanzwe afite COVID-19.Biterwa nigipimo cyanduye mukarere kabo niba bagaragaza ibimenyetso.Niba umuntu ukomoka mukarere gafite urugero rwa COVID-19 afite ibimenyetso bisanzwe byindwara kandi akabona ingaruka mbi, birashobora kuba bibi kandi bigomba gusuzumwa neza ukoresheje PCR.
Abashakashatsi kandi bajya impaka niba abantu bagomba kwipimisha (murugo, ku ishuri cyangwa ku kazi).Imikorere yikizamini irashobora gutandukana, bitewe nuburyo ikizamini gikusanya swab ikanatunganya icyitegererezo.Kurugero, ukoresheje ikizamini cya Innova, abahanga muri laboratoire bageze kuri sensibilité hafi 79% kuburugero rwose (harimo ingero zifite imitwaro mike cyane ya virusi), ariko rubanda rwiyigishije ubona gusa sensibilité ya 58% (reba “Ikizamini cyihuse: Birakwiriye murugo? ”) -Deeks yemera ko iyi ari igitonyanga giteye impungenge1.
Nubwo bimeze bityo ariko, mu Kuboza, ikigo gishinzwe kugenzura ibiyobyabwenge mu Bwongereza cyemereye gukoresha ikoranabuhanga rya Innova mu rugo kugira ngo hamenyekane indwara zanduye mu bantu badafite ibimenyetso.Umuvugizi wa DHSC yemeje ko ibimenyetso by’ibi bizamini byaturutse mu kigo cy’igihugu gishinzwe ubuzima, cyateguwe na Minisiteri y’ubuzima n’imibereho myiza y’abaturage (DHSC), ariko cyaguzwe na Innova kandi cyakozwe n’Ubushinwa Xiamen Biotechnology Co., Ltd. ikizamini cyakoreshejwe na guverinoma y'Ubwongereza cyasuzumwe cyane n'abahanga mu bumenyi b'Abongereza.Ibi bivuze ko ari ukuri, kwiringirwa, kandi ko bashobora kumenya neza abarwayi ba COVID-19 badafite ibimenyetso. ”Umuvugizi yabitangaje.
Ubushakashatsi bw’Abadage4 bwerekanye ko ibizamini byonyine bishobora gukora neza nkibyakozwe nababigize umwuga.Ubu bushakashatsi ntabwo bwasubiwemo urungano.Ubushakashatsi bwerekanye ko iyo abantu bahanaguye amazuru bakarangiza ikizamini cyihuse kitazwi cyemejwe na OMS, nubwo abantu bakunze gutandukira amabwiriza yo gukoresha, sensitivite iracyasa cyane nkiyagezweho nababigize umwuga.
Muri Amerika, Ikigo gishinzwe ibiryo n'ibiyobyabwenge (FDA) cyemeje uruhushya rwo gukoresha byihutirwa kwipimisha 13 antigen, ariko kimwe gusa muri Ellume COVID-19 ikizamini cyo murugo-gishobora gukoreshwa kubantu badafite ibimenyetso.Nk’uko byatangajwe na Ellume, isosiyete ifite icyicaro i Brisbane, muri Ositaraliya, iki kizamini cyagaragaje coronavirus mu bantu 11 badafite ibimenyetso, kandi 10 muri abo bantu bapimishije PCR.Muri Gashyantare, guverinoma y'Amerika yatangaje ko izagura ibizamini miliyoni 8.5.
Ibihugu / uturere tumwe na tumwe bidafite amikoro ahagije yo kwipimisha PCR, nku Buhinde, bamaze amezi menshi bakoresha ibizamini bya antigen, kugirango bongere ubushobozi bwabo bwo gupima.Kubera impungenge zukuri, ibigo bimwe bikora ibizamini bya PCR byatangiye gusa gushiraho ubundi buryo bwihuse kurwego ruto.Ariko guverinoma yashyize mu bikorwa ibizamini binini byihuse yise intsinzi.Hatuwe na miliyoni 5.5, Silovakiya nicyo gihugu cya mbere cyagerageje kugerageza abaturage bacyo bose bakuze.Kwipimisha cyane byagabanije kwandura hafi 60% 5.Icyakora, ikizamini gikozwe hamwe n’ibihano bidashyirwa mu bikorwa mu bindi bihugu ndetse n’inkunga leta itanga ku bantu bipimisha neza kugira ngo babafashe kuguma mu rugo.Abahanga bavuga rero ko nubwo guhuza ibizamini no kubuza bigaragara ko bigabanya umuvuduko wanduye kuruta kubuzwa byonyine, ntibisobanutse niba ubwo buryo bushobora gukorera ahandi.Mu bindi bihugu, abantu benshi bashobora kudashaka gukora ikizamini cyihuse, kandi abipimisha neza barashobora kubura ubushake bwo kwigunga.Nubwo bimeze bityo, kubera ko ibizamini byihuse byubucuruzi bihendutse cyane-$ 5-Mina avuga ko imijyi na leta bishobora kugura miriyoni ku gihombo cya leta cyatewe niki cyorezo.
Umukozi w’ubuzima yahise yipimisha umugenzi ufite izuru kuri gari ya moshi i Mumbai, mu Buhinde.Inguzanyo y'ishusho: Ihane Parajpe / AFP / Getty
Ibizamini byihuse birashobora kuba byiza cyane mugihe cyo kwisuzumisha kidafite ibimenyetso birimo gereza, amazu adafite aho kuba, amashuri na kaminuza, aho abantu bashobora guteranira uko byagenda kose, bityo ikizamini icyo ari cyo cyose gishobora gufata izindi ndwara zanduye ni ingirakamaro.Ariko Deeks yihanangiriza kwirinda gukoresha ikizamini muburyo bushobora guhindura imyitwarire yabantu cyangwa kubatera kuruhuka.Kurugero, abantu barashobora gusobanura ibisubizo bibi nko gutera inkunga gusura bene wabo mu bigo byita ku bageze mu za bukuru.
Kugeza ubu, muri Amerika, hatangijwe uburyo bunini bwo kwipimisha bwihuse mu mashuri, gereza, ibibuga by'indege na kaminuza.Kurugero, kuva muri Gicurasi, kaminuza ya Arizona muri Tucson yakoresheje ikizamini cya Sofia cyakozwe na Quidel i San Diego, muri Californiya kugirango igerageze abakinnyi bayo buri munsi.Kuva muri Kanama, yapimishije abanyeshuri byibura rimwe mu kwezi (bamwe mu banyeshuri, cyane cyane abo muri dortoir bafite icyorezo, bapimwa kenshi, rimwe mu cyumweru).Kugeza ubu, kaminuza imaze gukora ibizamini bigera ku 150.000 kandi ntabwo yigeze itangaza ko umubare wa COVID-19 wiyongereye mu mezi abiri ashize.
David Harris, umushakashatsi w’akagari gashinzwe gahunda nini yo kwipimisha muri Arizona, yavuze ko ibizamini bitandukanye bitanga intego zitandukanye: ibizamini bya antigen byihuse ntibigomba gukoreshwa mu gusuzuma ubwandu bwa virusi mu baturage.Yavuze ati: “Nuyikoresha nka PCR, uzogira ubwoba bukabije.”Ati: “Ariko ibyo tugerageza gukora-gukumira ikwirakwizwa rya virusi-antigen, cyane cyane iyo ikoreshejwe inshuro nyinshi, bisa nkaho bikora neza.”
Umunyeshuri wo muri kaminuza ya Oxford mu Bwongereza yakoze ikizamini cya antigen yihuse yatanzwe na kaminuza hanyuma yerekeza muri Amerika mu Kuboza 2020.
Amatsinda menshi yubushakashatsi ku isi arimo gutegura uburyo bwihuse kandi buhendutse.Bamwe bahindura ibizamini bya PCR kugirango byihutishe inzira yo kongera imbaraga, ariko byinshi muribi bizamini birasaba ibikoresho kabuhariwe.Ubundi buryo bushingira kuri tekinike yitwa loop-mediated isothermal amplification cyangwa LAMP, yihuta kurusha PCR kandi isaba ibikoresho bike.Ariko ibi bizamini ntabwo byoroshye nkibizamini bishingiye kuri PCR.Umwaka ushize, abashakashatsi bo muri kaminuza ya Illinois muri Urbana-Champaign bakoze ubushakashatsi bwabo bwihuse bwo kwisuzumisha: ikizamini gishingiye kuri PCR gikoresha amacandwe aho gukoresha amazuru, basimbuka intambwe zihenze kandi zitinda.Igiciro cyiki kizamini ni $ 10-14, kandi ibisubizo birashobora gutangwa mugihe kitarenze amasaha 24.Nubwo kaminuza yishingikiriza kuri laboratoire ku rubuga kugirango ikore PCR, kaminuza irashobora gusuzuma buri wese kabiri mu cyumweru.Muri Kanama umwaka ushize, iyi gahunda yo kwipimisha kenshi yemereye kaminuza gutahura ubwiyongere bw’indwara z’ikigo no kuyigenzura ku rugero runini.Mu cyumweru kimwe, umubare w'imanza nshya wagabanutseho 65%, kandi kuva icyo gihe, kaminuza ntiyigeze ibona impanuka nk'iyi.
Boehme yavuze ko nta buryo bumwe bwo kwipimisha bushobora guhaza ibikenewe byose, ariko uburyo bw'ikizamini bushobora kumenya abantu banduye ni ngombwa kugira ngo ubukungu bw'isi bwifungure.Yavuze ati: “Ibizamini ku bibuga by'indege, ku mipaka, aho bakorera, amashuri, aho bivuriza - muri ibi bihe byose, ibizamini byihuse birakomeye kuko byoroshye gukoresha, bidahenze, kandi byihuse.”Icyakora, yongeyeho Ibyo byavuzwe, gahunda nini y'ibizamini igomba gushingira ku bizamini byiza bihari.
Muri iki gihe Umuryango w’ubumwe bw’ibihugu by’Uburayi w’ibizamini byo gusuzuma COVID-19 ni kimwe n’ubundi buryo bwo gusuzuma, ariko impungenge z’imikorere yuburyo bumwe na bumwe bwo kwipimisha zatumye hashyirwaho amabwiriza mashya muri Mata umwaka ushize.Ibi birasaba ababikora gukora ibikoresho bipima byibuze gukora COVID-19 mugihe cyubuhanzi bugezweho.Ariko, kubera ko ingaruka zo kwipimisha zakozwe mu kizamini cy’abakora zishobora kuba zitandukanye n’iz'isi isanzwe, umurongo ngenderwaho urasaba ko ibihugu bigize uyu muryango byabigenzura mbere yo gutangiza ikizamini.
Boehme yavuze ko, nibyiza, ibihugu bitagomba kugenzura uburyo bwose bwo gupima.Laboratoire n'abakora ku isi yose bazakoresha protocole isanzwe (nk'iyakozwe na FIND).Yavuze ati: “Icyo dukeneye ni uburyo busanzwe bwo gupima no gusuzuma.”Ati: “Ntabwo bizaba bitandukanye no gusuzuma imiti n'inkingo.”
Igihe cyo kohereza: Werurwe-09-2021