Gwaran gwajin lafiya suna da muhimmin bangare na kulawa. Zanewa zai iya ɗaukar takardun tambayoyi masu sauki, jarrabawar gwaje-gwaje, gwajin rediyo (misali duban dan tayi , X-ray) ko hanyoyin (misali gwajin gwaji). Amma kawai saboda an gwada gwajin don dalilai masu nunawa, ba yana nufin cewa yana da gwaji mai kyau . Tabbataccen fasaha ya zama dole amma bai isa ba don gwajin gwaji.
Haɗuwa da gwaji mai kyau, cututtuka, tsari na haƙuri da kulawa ya samar da tsarin kiwon lafiyar.
Binciken vs. Gwajin Dubawa
Ana iya yin jarrabawar likita don bincike ko ma'ana, dangane da ko mai haƙuri yana da alamu ko bayyanar cututtuka da suka shafi cutar da ake tambaya.
Dalilin gwajin likita na likita shi ne tabbatar da kasancewa ko babu cuta a mutum tare da alamu ko alamu na cutar. Za a iya gwada gwajin gwaji don biyan gwajin gwaji mai kyau. Wadannan su ne misalai na gwaje-gwaje na bincike:
- Kwalejin cutar Cardiac don bincika cututtukan zuciya a cikin mutum da ciwon kirji
- X-ray na Chene don neman ciwon huhu a cikin mutumin da tari da zazzabi
- Kammala ƙimar jini don neman anemia a cikin mutum da gajiya
- Kwayoyin halitta a cikin mutum wanda ke da alamun mammogramcin magunguna
Dalilin yin nazari shine ya gano wata cuta kafin alamu ko bayyanar cututtuka ya bayyana don ya ba da izinin farawa.
Wadannan su ne misalai na gwaje-gwaje na gwaje-gwaje da Ƙungiyar Ayyukan Tsaro na Amurka ta amince da su:
- Colonoscopy, sigmoidoscopy, ko jarrabawar jarraba don gano ciwon daji na maganin ciwon daji a cikin manya shekaru 50 ko tsufa wanda basu da alamu ko alamun cutar.
- Jarabawar HIV a matasa da kuma tsofaffi masu shekaru 15 zuwa 65 wadanda basu da alamun ko alamun HIV.
- Gwaji ga irin 2 ciwon sukari a tsofaffi mai tursasawa tare da ciwon jini (duk da haka bi ko ba tare da izini ba) fiye da 135/80 mm Hg
- Jaraba ga cutar ciwon sikila a jarirai
Ana gwada gwaje-gwaje na gwaje-gwaje kullum don ƙara yawan kariya. Alal misali, a game da ciwon ciwon sankarar mahaifa-wanda yake haifar da papillomavirus ɗan adam (HPV) -an ganewar ganewar yanzu za'a iya goyan bayan jarrabawar gwaje-gwaje ta al'ada da kuma gwaji na HPV DNA. Sakamakon binciken binciken na kwanan nan ya nuna cewa gwaji na HPV ya fi damuwa. Saboda haka, yawancin masana, suna jayayya cewa ya kamata ya zama fasaha ta farko.
Mene ne yake Neman Gwajin Juyin Halitta?
Kawai saboda muna da gwaji mai mahimmanci domin gano cutar ko rashin hauka, wannan ba yana nufin gwaji ya dace da nunawa ba. Alal misali, zane-zane na zane-zanen mutum zai gano abubuwan da ba su da yawa a yawancin mutane, amma ba a ba da shawara a matsayin jarrabawar jarrabawa ga mutanen da suke lafiya. Wani jarrabawa ne kawai ya dace don nunawa idan an yi shi a cikin mahallin da ya dace, wanda ya shafi tambayoyin game da cutar kanta, mutanen da suka kamu da cutar, da kuma magani.
Ka'idojin Wilson da Jungner da aka bayyana don kyakkyawan shirin yin nazari a cikin takarda na 1968.
Ƙungiyar Lafiya ta Duniya ta amince da waɗannan sharuddan guda 10 wadanda har yanzu suna kasancewa tushen ga yawancin tattaunawa akan shirye-shiryenta a yau.
- Yanayin da ake bukata ya kamata ya zama babban matsalar lafiya.
- Ya kamata a sami magani mai karɓa don marasa lafiya da cutar da aka sani.
- Abubuwan da za a gano don ganewar asali da kuma kulawa ya kamata su samuwa.
- Dole ne a sami mataki marar ganewa ko tsinkaye na farko.
- Dole ne ya zama gwajin dace ko jarrabawa.
- Ya kamata jarrabawar ta yarda da yawan jama'a.
- Tarihin halitta na yanayin, ciki har da cigaba daga latent don bayyana cutar, ya kamata a fahimce shi sosai.
- Dole ne a sami manufar amincewa da wanda zai bi da marasa lafiya.
- Kudin neman bincike (ciki har da ganewar asali da kuma maganin marasa lafiya da aka bincikar) ya kamata a daidaita tattalin arziki dangane da yiwuwar kashe kuɗi akan aikin likita.
- Binciken bincike ya kamata a ci gaba da aiki amma ba aikin "sau daya ba"
Ka lura cewa samfurin da ke sama ba sa mayar da hankali akan gwajin kanta ba, amma maimakon mahallin da ake amfani dashi. Idan har ma ba a cika ka'idodin ba, to, chances suna da wuya cewa jarrabawar gwaje-gwaje za ta inganta lafiyar jama'armu.
Juyin Juyin Halitta
Wilson da Jungner ba su yi niyyar dabarun da aka tsara don zama amsar karshe ba, amma don kara karfafa tattaunawa. Fasaha ta ci gaba da ci gaba, yana ba mu damar gano karin cututtuka a wani wuri na farko. Amma gano wani cuta ko rashin ciwo ba koyaushe inganta lafiyar jiki ba. (Alal misali, menene amfani da nunawa ga cutar idan babu magani a gare shi?) An tsara matakan zane-zane da aka tsara don gane muhimmancin lafiyar yau.
Kayan nazarin kwayoyin halitta yana zama muhimmin bangare na cigaba, ciki har da nunawa a ciki. Yawancin gwaje-gwajen kwayoyin yanzu suna samuwa, kuma masu sana'ar kulawa na farko sun buƙaci su iya ba da shawara ga marasa lafiya don su iya yin zaɓin bayani. Wasu masana sunyi gargadin cewa gwaje-gwajen kwayoyin ba za a yi amfani da su ba. Dole ne marasa lafiya su fahimci amfani da kasada kafin su karbe su. Bugu da ƙari kuma, mutanen da ke da babban haɗari na tasowa wani nau'i na kwayoyin halitta zasu iya amfani da su kamar yadda suke magance wasu bangarori na lafiyarsu, irin su abinci mai gina jiki, abubuwan muhalli, da motsa jiki.
Tambaya mai mahimmanci da za a tambayi kafin karɓar duk wani gwaji don dalilai masu ma'ana shine "Shin jarrabawar gwajin ta haifar da lafiyar lafiya?"
> Sources:
> Anne Andermann et al. Binciko Wilson da Jungner a cikin Age Age: Wani Bincike na Kayan Gidawa a cikin shekaru 40 da suka wuce. Bulletin of World Health Organization 2008; 86 (4): 241-320.
> Harris R et al. Binciken Abubuwan Kulawa don Tattaunawa Shirye-shiryen Shirye-shiryen Shirye-shirye: Rahotanni daga 4 Yanzu da kuma Tsohon mambobi ne na Ƙungiyar Ayyukan Tsaro na Amurka. Epidemiol Rev (2011) 33 (1): 20-35.
> Tota J, Bentley J, Ratnam S, et al. Gabatarwar gwajin gwaji na HPV a matsayin Fasaha na Farko a Cervical Cancer Screening: Yin aiki a kan Shaida don Canji Canjin Cigaba Yanzu. Medicine Preventive , 2017; 98 (Batu na Musamman: Tsarin Kwafi a Citical Cancer Screening): 5-14.
> Ƙungiyar Ayyukan Tsaro ta Amurka. Bayanan USPSTF A da B. Wilson JMG da Jungner G. ka'idodin da kuma aiwatar da yaduwar cutar. Takardun Kiwon Lafiyar Jama'a No. 34. Geneva: Hukumar Lafiya ta Duniya; 1968.