Iziswabi Zokusambala Kwemithi: Ukubonisa Amasilimi Ngokuphelele

Ngani amaswabu okuvumela amaviri ayinika ukubhalisa amadoda abuyele ngokuphelele nokuphathelana

Izindlela zokugcina i-nucleic acid: Ngani isithi samaswabu nesikhundla sakho sokuqondisa sibalulekile

Iziswabi zesampuli zezinhlobo zeziviro zezinye zezikhathi zezokusha zisebenzisa indlela yombili: ukuthenga kahle kwamaphuzu weziviro kusuka kwezinye zezibhala zezindawo zezimvume, emva koko ukuvulula kahle nokugcina konke kumelusi wokuthumela ukwenza ukuzilungiselela kwezinhlobo zezinhliziyo. Iziswabi eziqondile—ezakhiwe ngamakhulu amaningi amanayloni okuphambili—zakha izihlalo eziningi zokukhanya okunamuhla okusebenza ngokusebenzisa ukuthenga kwamaphuzu okukhanya ukuthenga amaphuzu eneziviro neselula yezindawo zezimvume. Le ndlela yokukhanya iyakwakha isampuli esikhulu ngokwesikhundla, futhi iyakwakha ukuvulula kahle: kungenani ama-80% yezinto ezithengwe ziyavululwa kumelusi, kubonakala ukuthi kungenani ama-20–40% yezinto ezithengwe ngokusetshenziswa kwezinye iziswabi zezifiber zezirayon. Ukuvakasha kuthiwa ukuthi isikhundla sokukhanya kuyathandana ngokushisana nokuthenga kwamaphuzu weziviro (West et al., 2022), okukhombisa ukuthi indlela yokukhanya iyadumela ukuthenga kwamaphuzu. Ngokulingana, iziswabi zezirayon zezikhubeka zinezinhlobo zezifiber ezingazange zizame ukuthenga iziviro neselula yezindawo zezimvume, okuthintisa inombolo yezinhlobo zezinhliziyo ezinokuthengwa kwe-PCR. Ngokuthatha isikhundla sokukhanya nesikhundla sokufaka izifiber, iziswabi eziqondile zinakha isikhundla esifanayo nesifanayo phakathi kwezincwadi zezokusha nasezincwadi zezokuthenga—okuthintisa ukuguqula kwezincwadi zezokusha futhi okukhomba izinhlobo zeziviro zezinhliziyo ezibalulekile kusukela kwezokuthenga kuze kwezokuzilungiselela.

Iziswabi zesikhathi sezinkundla neziswabi zesi-rayon neziswabi zesi-senthetik: Ukulingana kwezindlela zokubuyisa iziviro

Ukuphepha kwesilinganisi sokudlala kweziviro zezinyawo zokufa kuzokuthi iswabi sibuyeze iziviro eziyisilungile, ezinamphumela ngokuphambuka, noma ziyisilungile. Izithunzi ezintathu eziphakeme kakhulu zihlukene kakhulu ngokuphepha kwazo:

Amaswabi esikhundla esihlukene asinika ukubuyisela okuhle kakhulu ngokwezinye zezindawo zokugcina kodwa futhi ngokwezinye zezindawo zokugcina okuphambili okuzimele ekugcineni nokuvuleka. Umsebenzi wokwakhiwa kwe-2010 wabonisa ukuthi amaswabi esikhundla esihlukene asekhalini ayabuyisela ukuthi kubonakaliswe izinkambo zokufa ngeminyaka yezinkulungwane ezingaphezu kwe-30% kulayoni—ngokuphakeme kakhulu ngokuthi kuvuleka kahle kanye nokuvuleka ngokuphelele (Verhoeven et al., 2010). Nakuba amaswabi esikhalini esekhalini asinika ukubuyisela okuhle kulayoni, isithembiso sayo sokugcina sibonakala kwezinye izindawo zokugcina, okuzimela ukuthi kubuyiselwa okuncane. Kumaqondiso okuhle kwezincwadi zokusebenza noma kumaqondiso okuhle okwenziwa ngokwesibonelo—kusukela kumaqondiso okuhle okwenziwa ngokwesibonelo—amaswabi esikhundla esihlukene ayisibonelo esisodwa ngokwesibonelo sokubuyisela okuhle kakhulu.

Izindlela zokusithatha ezisodwa: Ukubizana kwezinkambo zokufa zamaswabi nezinkinga zokusebenza noma kumaqondiso okuhle okwenziwa ngokwesibonelo

Ukuthatha kwezinkambo zokufa kwezinye izindawo zokugcina vs. Ukuthatha kwezinkambo zokufa kwezinye izindawo zokugcina zokugcina ngokwesibonelo vs. Ukuthatha ngokwesibonelo: Iziqukwe zokubuyisela okuhle, ukuthanda ukusebenza, nokuthanda ukuthatha ngokwesibonelo

Ukuthatha isampulu yase-nasopharyngeal (NP) sisebenza njengomthombo wokuziphatha okwenzekayo kubhekwa ngokupheleleyo kwezinye izilungisi zezinyawo, esinika isensitivhithi esiphezulu—ikakhulukazi lapho ubukhulu be-virus buncane. Kwenziwa ngabafundi abaqhubekileyo besebenzisa izikhombisa ezifunqwe ngokufunqwa, ukuthatha isampulu yase-NP kusenza ukuthi kuthathelwe inkulu yezikhombisa ne-virus ekhulula. Kodwa ukuthi kuyisikhathi esihlukile nesibonakalo sokusebenzisa abafundi abaqhubekileyo kusenziwa ukuthi kubekwe kuncane lapho kunezinhlanhla zokuthatha isampulu. Ukuthatha isampulu yase-anterior nasal (AN)—okwenzeka ngokuvamileyo kumid-turbinate—kuyisikhathi esincane kakhulu futhi kusenziwa ngokwakho. Amasampulu ase-AN akhona 85–95% yokuqinisa kwe-NP kubantu abanemitha, kodwa ukusebenza kwawo kuncane kakhulu kubantu abangamitha (CDC, 2022). Ukuthatha isampulu ngokwakho noma ngokusebenzisa amasampulu ase-saliva asenziwa ukuthi kususwe ukuthi kubekwe kuncane kakhulu kwezinyawo zokuziphatha, kusenza ukuthi kubekwe kubanzi kakhulu nokuthandana kwebhizinisi. Lapho kusendiswe ngokufundisa okuncane, ukuthatha isampulu ngokwakho kusenza ukuthi kubekwe kubanzi kakhulu kwezinyawo zokuziphatha. Ukuchaza okuhlanganisa kuyisikhathi esihlukile: nakuba amasampulu ase-AN athathelwe ngokwakho ayadala 5–15% yezinyawo ezingcwele kakhulu ngokulinganisa ne-NP, ukuthola kokuthi kubekwe kubanzi kakhulu, ukuthola kokuthi kubekwe kubanzi kakhulu, nokuthola kokuthi kubekwe kubanzi kakhulu kusenziwa ukuthi kubekwe kubanzi kakhulu—ikakhulukazi lapho kubhekwa ngokubanzi kwebhizinisi nokuthola okuncane kwezinhlanhla zokuthatha isampulu.

Izinhlangano Zokuthenga Okwesibonelo Ngokusebenzisa Izihlombe Zokuthenga Amavirus Ukufunda Okwesikhathi Esinye

Ukuhlolwa ngokuhlanganiswa ukuhlanganisa amasampula amaningi e-swab ibe isampula elilodwakukhulisa amandla elebhu ngaphandle kokwandisa isikhathi sokuphendula. Isampula ngalinye liqoqwa kusetshenziswa isampula elihlosiwe, eliqinisekisiwe lokuthatha amasampula, bese likhiqizwa libe ishubhu elihlanganyelwe lesimo esihambisanayo. Ubukhulu be-pool ngokuvamile buvela ku-5 kuya ku-20, buqondaniswe nokwanda kwendawo kanye nemikhawulo yokuthola ukuhlolwa. Ucwaningo lokuqinisekisa oluhlolwe ngontanga luthole ukuthi ukuhlanganisa ama-swabs angu-10 angaphambili ekhaleni kunciphisa ukuzwela ngo-36% kuphela uma kuqhathaniswa ne-PCR ngayinyengisho naseduze nomkhawulo ophansi wokutholwa kwe-assay (PLOS ONE, 2021). Impumelelo incike ekusetshenzisweni kwama-swabs nezingosi ezivunyelwe i-eSwab noma izinhlelo ezifanayo; inhlanganisela engavumelani ingadala ukuwohloka kwe-nucleic acid. Amaqoqo amahle enza ukuba kusetshenziswe izivivinyo ezintsha zesampula ngayinye; amaqoqo amabi asusa bonke abafaka isandla ngasikhathi sinye. Lendlela igcina izinto zokuhlola, inciphise izindleko zokuhlola, futhi isekele ukuqapha okuvamile ezikoleni, ezindaweni zokusebenza nasezindaweni zokuhlala. Ukusebenza kwayo emhlabeni wangempela kuncike endleleni yokuqoqa esezingeni elifanele kanye nokuthutha ngesikhathi esifaneleokubili okubalulekile ukuze kulondolozwe ukuphelela kwe-nucleic acid ngaphambi kokucutshungulwa.

Ukuvuselela Kwempilo Yokuziphatha Kwezikhombisa Zokuzithatha Iziqu: Ukuthabathwa, Ukuthumela, Nokusebenza Okuhle

Ukuhambisana Kwemithombo YokuThumela Emaphandleni Ezingaphansi Kokuphakama Kwesikhathi Nokuthabathwa Kwemithombo Yomshini Wokuziphatha Iziqu

Ukuphelela kwe-RNA yegciwane kuncike kakhulu ekuhambisaneni phakathi kohlobo lwe-swab kanye nendawo yokuthutha. Izingxenye zokuhambisa ezijwayelekile (UTM) ezisekelwe usawoti we-guanidine nezingxenye zokuhambisa amagciwane (VTM) zenza ama-pathogen angabi khona futhi zivimbele ama-ribonucleases, okwenza kube nokugcinwa okuzinzile ekushiseni kwendawo. Ukuhlolwa kwe-CDC kuqinisekisa ukuthi i-SARS-CoV-2 RNA ihlala itholakala ku-UTM kuze kube yizinsuku ezingu-14ngokwehla okungaphansi kuka-1 log10 komthwalo wegciwanekuyilapho i-influenza A RNA ikhombisa ukuzinza kwezinsuku ezingu-10 ngaphansi kwezimo ezifanayo. Ama-swabs agcwele kakhulu adlula i-rayon kulezi zinhlelo: ukwakheka kwawo okwenziwe ngobunjiniyela kuthuthukisa ukusebenza kahle kwe-elution, okwenza ukubuyiselwa kwe-nucleic acid kube kukhulu ngisho nangemva kokugcinwa isikhathi eside. Nokho, ukuhlangana kwe-swabmedium okungahambelani, kusheshisa ukuwohloka kwe-RNAizifundo zibika ukulahleka okukhulu okungu-50% kungakapheli amahora angu-48 uma kusetshenziswa inhlanganisela engaqinisekisiwe (Li et al., 2020). Isiqondiso somthethokuhlanganise nezincomo ze-WHOsigcizelela ukusetshenziswa kwama-swabmedium pairs kuphela afaneleke kusengaphambili aqinisekiswe ezifundweni zokuqina ezilawulwayo. Ezimweni ezinemithombo elinganiselwe noma ezingasetshenziswanga, ukukhetha ukuhlanganiswa okunjalo okuqinisekisiwe akunakuphikiswa ukuze kugcinwe ukuthembeka kokuxilonga lapho ukuhlinzekwa kwe-cold-chain kungatholakali.

Imithambo Yokuqonda Ngokuphelele Yokusebenza Kwezindlela Zokugcina Amaswabi We-Viral Kwezindawo Zokuhlola Nezindawo Zokusebenza

• Ukuzimisa Kabefore Ukugcina : Sichecka ukuthi iswabhi–isibonelo sokugcina sifanana ngokwesikhundla sokugcina; amaswabhi we-flocked nylon nge-UTM noma VTM ayasho kakhulu.
• Indlela yokugcina : Landela umbiko ngokucophelela—faka kuqonde lokugcina (isibonelo: NP: uma kufika emuva kwesibhakabhaka; AN: emaphakathi kwezintambo), yenza umgudu omncane ngemizuzu eyi-5–10, ususa ngaphandle kokuthi ubheke emasweni angaphandle.
• Ukuthumela Ngokushesha : Faka iswabhi kusibonelo sokugcina ngemizuzu eyi-30; vula noma vula isihlangu esihlukanayo ukuze uqinisekise ukuthi kubhekene ngokuphelele nokuvulwa okungafihli.
• Ukubhala Isibhakabhaka Nokuthenga : Bhalisa i-ID yomuntu, usuku/isikhathi sokugcina, nokuhlelo lweswabhi ngqo kusitshixo; sebenzisa izibhakabhaka zebharicodes ukuze ushukume izingxenye zokuphatha ngokwezinkampani eziningi.
• Ukugcina Nokuthumela : Gcina ku-28°C uma ukucutshungulwa kwenzeka kungakapheli amahora angu-72; qandisa ku-70°C ukuze ugcine isikhathi eside. Phambuka kuphela ezidingweni zeketeni elibandayo uma ukuzinza ekamelweni sekuvunyiwe ngokusemthethweni ngenhlanganisela ethile yesisindoesiphakemeesiyimbangela yesifo.
• Ukuqinisekiswa Kwekhwalithi : Ukuhlola njalo amakhono; sebenzisa amasampula okuhlola ukuze uhlole indlela yokuqoqa, ukuphathwa kokuthembeka, nokuhambisana neketanga lokugcina.

Imibuzo Evame Ukubuzwa

• Uyini umehluko phakathi kwama-flocked nama-rayon swabs? Ama-swabs agcwele anezintambo ze-nylon eziqondile ezandisa ukuqoqwa kwamasampula nokukhululwa, kuyilapho ama-rayon swabs esebenzisa izintambo ezihlanganisiwe ezingase zibambe amagciwane, okunciphisa ukuzwela kokutholwa.
• Kungani kusetshenziswa ama-swabs agcwele abantu ukuze kuhlolwe i-COVID-19? Ama-swabs agcwele ayasebenza kakhulu ekuqoqeni nasekukhululeni izinto ezibangelwa igciwane, okwenza kube kuhle ukuthola amagciwane anokuzwela okuphezulu.
• Ingabe amasampula e-swab azithathela wona athembekile? Yebo, izibhanku zesinye sezinyawo zokuzithatha kuzoba ne-85% noma ngaphezulu yokuqondisa kunye nezibhanku zesinye sezinyawo zokuthatha ngabaphathi, ikakhulu kubantu abanemisemo.
• Izinto zokuphumeza zokuphuma kwezibhanku zokugcina ziziphi? Ukuphuma kwezibhanku kunciphisa izindlela zokuthenga futhi kusave amasampuli, kodwa kuyamela ukusebenza kanye nokwakha kwezinhlelo zokuphuma, ikakhulu lapho kufakwa kwezinhlelo zokuphuma ezingaphezulu.
• Kufanele izibhanku zokugcina zilungelwe njani? Kufanele izibhanku zilungelwe kwi-2–8°C uma zifakwa kulesikhathi sokuphuma ngaphansi kwe-72 amahour, noma zilungelwe kwi-−70°C uma kufanele zilungelwe ngaphandle kwe-72 amahour, ngakho ukuthi kungafanele ukulungela kwi-temperature yendawo uma akukhombiwe ukuthi kungasebenza kule ndawo.