TB NATNA LEH A ENKAWL DAN

• Mrs. R. Lalhmudiki, IEC Officer,
  

State Health Society (TB Control), DHS

 

All India Radio Programme pawimawh tak 'In Damtlang Em?' tih kaltlang hian Doctor-te leh damdawi lama thiamna neite'n mipuite hnenah hriselna kawnga zirtirna an lo pe tawh thin a, hetiang programme pawimawh tak duan chhuah leh hman tangkai a ni hi a lawmawm hle a ni. He programme atang hian mipui mimirin hriselna kawnga zir tur tam tak an zira an hriat belh rualin damdawi lama thawk te pawhin awlsam leh zau zawkin hriselna lam zirtirna kan puandarh theihna kawng a lo ni bawk si a; a tangkaiin a daihzai hle a ni. Tun tumah hian TB natna chungchang sawi kan tum dawn a ni.

TB natna hi Mizovin Ngawr hri kan ti a. A hrik hi Mycobacterium Tuberculosis a ni. Kum 1882-ah German mi thiam Robert Koch-an a hmuchhuak a ni. Mizoramah chuan kum 1938 vel atang khan kan hre ve tan chauh a, lehkhathiam hmasa Pu L. Biakliana leh Pu Kaphleia, Mizo zinga an lehkha ziak thiam avanga hming dai tawh ngai lo turte kha kum 1937 khan TB natna tuarin an thi nghe nghe a ni. 

TB natna hi khawvel pumpuiah hian natna tlanglawn leh do hneh loh pathum zinga pakhat ani a, khawvela mihring awm zawng zawng zinga hmunthuma thena hmunkhat hian TB an vei mek a ni. Mi thiamte chhut dan chuan natna kan vei thin zinga sawma pasarih vel hi chu kan nunphung leh ei leh in te kan uluk chuan kan pumpelh thei a, chung zingah chuan TB hi a tel nghe nghe a ni. World Health Organization in a tarlan dan chuan khawvel pumah hian kum tin mi maktaduai 8 velin TB an vei thar a. TB vanga thi kum tin mi nuai 2 chuang an awm. 

 

India ramah pawh hian TB natna hi kan tuar nasa hle mai a, puitling chin chauh ngaihtuah pawhin sawma pali zelin TB hrik an pai a, TB vei te hi a tam ber chu kum valai, kum 25-44 inkar chhungkua leh khawtlang tana tangkai thei ho an ni. Chuvangin ram chhung sum leh pai dinhmun pawhin a tlakhniam phah nasain retheihna a ti zual em em a ni. TB avangin minit khat leh a chanve chhungin mi pakhat a thi zel a, ni tin mi sangkhat aia tam an thi ziah tihna a ni a, kumkhat chhung phei chuan TB vang liau liauin mi nuainga lai an thi ziah tihna a nih chu. Sikserh te, AIDS te leh ram luma natna awm thei dang zawng zawng avanga thi zat aiin TB vanga thi zat a tam zawk a ni.

Vairamah phei chuan chhungkaw nu berin TB a vei hlauh chuan a pasal leh a chhungte'n thinhrikin an hnawtchhuak fo thin a, chumi hlauh avanga mahni TB vei inzep pawh thahnem tak an awm mek a ni. Sum leh pai tam tak hloh anih bakah kumtin India ramah sikul naupang 3,00,000 zet te hian an nu leh paten TB an vei avangin zirna an chhunzawm thei lova. Hmeichhia TB vei 1,00,000 zet hi chhungten an lungten, tihhrehawm leh diriam hlawh an awm bawk.

   

Mizoramah ngei pawh hian TB vei kan thahnem ve hle mai a, ni tin TB vei thar 5 zel hmuhchhuah an ni. Amaherawhchu TB hian Sikserh leh natna dang thenkhatte anga chawplehchilha thih thutna a thlen khat vang hian nge ni mipui mimir hian kan hlamchhiah deuh niin a lang a; a lehlamah chuan a hlauhawm zia leh enkawl thuai chuan awlsam taka dam leh mai thei anih si zia te hi kan hrechiang tawk lo pawh ani mahna.

TB vei hmuhchhuah tharte hi chi hnih - an khaka TB hrik awm ngei leh an khaka TB hrik hmuh chiah loh, mah se TB vei ni ngeia lang si te in then an ni a; TB vei, an khaka TB hrik hmuh ngeite hi awlsam taka mi dangte kaichhawnga TB semdarhtute an niin hetiang mi, enkawlna dawng lo te chuan kum khatah mi 10-15 vel TB an kaichhawng thei thin a ni. 

Kum 2009 chhung khan Mizoramah TB vei thar 2538 hmuhchhuah an ni a, an zinga mi 570 te chu an khaka TB hrik hmuh ngei an niin chung zinga 91% te chu enkawl dam an ni. 

 

Heng TB vei thar kan tihte hi damdawi lama thawktute'n kan va zawn hmuhte ni lovin daktawr hnena inentir nachang hriate chauh an ni. A chhan chu kan damsam loh hian a tir tea inenkawl thuai a tha tih hre reng chung pawh hian mi tam zawk hi chuan loh theih loh nia kan hriat hunah chauh daktawr kan pan thin ti ila kan tisual tam awm lo ve. Daktawr pan si lova mahni inlama tuar mek engemaw zat awm turah ngai ila, chutiang han ngaihtuah chuan kan ramah hian TB vei hi tuna kan chhinchhiah mek zat aia tam fe an awm ngei a rinawm tlat a ni.

TB han tih mai hian mi tam ber ngaihtuahna chu chuap lamah a kal nghal thin a, a dikna chen pawh a awm a ni. TB hi chi hnih, chuap TB leh chuap pawn lam TB ah then hran ani a, chuap pawnlam TB tia kan sawi theih te chu Ruhah te, Ruh chuktuahah te, thalbeah te,thluak tuamtu kawrah te, kan chaw ei kalkawng tluanah te, kalah te, pum leh vun leh taksa dang dangah te pawh a awm thei tho a ni. Kan taksa ah hian sam, vun leh ha tih loh hi chu a TB thei vek a ni. TB vei zawng zawng zingah Chuap TB vei an tam ber a, Chuap TB vei hi chuap pawn lam TB vei aiin a let li zetin an tam a, chubakah midangte hnena TB hrik sem darhtu an ni. Ruh leh ril TB te aia chuap TB an tamna chhan pawh hi chuap TB vei mekte'n a hrik an theh darh zau vang a ni ber mai. Chutih ruala kan hriatreng tur thil pawimawh tak erawh chu chuap TB vei zawng zawng hi mi dangte tan an hlauhawm lo tih hi a ni tlat mai. Chuap TB vei chu daktawr hnenah a inentir thuai a, damdawi hmanga enkawl nghal vat anih chuan enkawlna a dawn tan atanga chawlhkar hnih a ral chuan mi dangte kaichhawng thei lovah ngaih a ni thin.

 

    Puitlingah TB vei lanchhuah dan langsar deuh deuhte chu chawlhkar hnih emaw a aia rei khuh reh thei lo te, chawhnu lama khawsik ser ser te, zan mut hlana thlan chhuak te, awm na leh thawk harsa te, chaw ei tui lo te, chau hluah hluah te, khak thi te, rihna tlahniam te a ni ber a; khuh pahin khak pawh a awm deuh zel a ni. Khuh reh thei lo kan tih awmzia chu khuh damdawi pangngaia enkawl pawha reh mai thei lo tihna a ni.       

           

Naupang chuan a taksa awmdan a sawifiah thiam loh avangin puitling angin TB vanga insawiselna hi naupang zingah a chiang lo va.Naupang zingah rau rau chuan kum 5 hnuailam hian TB an vei duh bik a, a vei mekte atangin an kai awlsam bik bawk a; chuvangin puitling, chuap TB vei mek awmna chhungkuaa naupang kum 6 hnuai lam awm apiang chu anmahniah sawi tur emaw hmuh tur emaw a awm lo anih pawhin TB enkawltute hnenah hruai emaw an chanchin hriattir thuai tur a ni a; damdawi 'prophylaxis' pek tur an ni. Naupang thang thei lo te, chaw ei tha duh lo reng te, thinchhia emaw nawrh hrat tak te hi TB vei nia rinhlelh tur zinga mi an ni bawk.

   

Chuap pawn lam - ruh te, ril te, thalbe leh taksa hmun dang -TB avang hian damlovin insawiselna a nei tam vak thin lo va, a nei anih pawhin chung atang chuan TB vang a ni ang tih rinhlelh nghal mai a harsa hle thin a ni. Ahmaa kan sawi tak khawsik leh khuh te kha hetiang damlo chi-ah hi chuan an lansarh tawh loh avangin an nat dan kha TB vang a ni ang tih rinhlelh mai a harsa lehzual a, chuvangin damdawi in changtlung takah lo chuan TB an vei a ni tih hriatchhuah a harsa hle thin a ni. Entir nan, Ruh TB anih chuan khawsika a intan hnuah emaw ruh TB lai chu a lo na thin a, damlo awmdan leh a ruh na lai kan chhuizawn atangin thil awmdan chu a lo lang ta chauh thin a ni. Damlo tam tak chu damdawi chi hrang hrang hmanga enkawl an niha an thatpui loh hnuah TB an lo ni reng tih hmuhchhuah te an ni nual a ni.

       

Chuap TB vei mekin midang a kaichhawn theih dan awlsam ber leh tlanglawn ber chu TB hrik a khuh chhuah atangin a ni a,a khuh leh hahchhiau leh khak chhak zawngin natna hrik tam tak a paih chhuak thin a ni. Chung TB hrik a paih chhuah te chu boruakah leng velin a kiang hnaia awm te'n an lo hip lut a, a hip luttu chuan taksa chak loh vang emaw, natna do theihna a tlakchham phei chuan hun rei lo te hnuah TB a lo vei ve ta mai thin a ni. He mi pumpelh leh tih tlem nana thil pawimawh tak, awmdan mawi ni nghal bawk si chu khuh leh hahchhiau zawnga rawmawl emaw a ka leh hnar hup zel te, khak leh chil chhak mai mai loh te hi a ni.

 

TB vei thar kan awm zel lai hian a vei mek la dam lo thahnem tak an awm tih hi hriat tel a tul a. Mizoramah ngeiah pawh hian TB enkawlna dawng tawh, a hunbi kim hmaa mahni thua bansan ta mai te, an damdawi ei thatphaha in hriat vang emaw, thatpui chuang lova in hriat vang emawa mahni thua ei chhunzawm ta lo te leh chhan dang dang vanga enkawl fumfe loh an tam hle a; TB enkawlna lama thawktute'n an zawn hmuh zawh tak loh pawh thahnem tak an awm mek a ni. Chuvang chuan he natna hlauhawm tak hi kan ramah hian englai pawhin hrileng angin kan tuar thei ani tih hria in sawrkar leh mipui te kan zavaia kan tan tlan a pawimawh em em a ni.

 

Chuvangin ei leh in tha,man to tak tak eiin in thei lo mah ila, kan nun kan uluk a, taksa mamawh chin chauh kan eia kan in chuan natna hrik tam tak chu kan thunun thei a ni tih i hria ang u.

TB ENKAWLNA DAN THAR THATNA TE

 

 

Tun tuma kan thupui sawi tur chu TB enkawlna dan thar thatna sawi kan tum dawn a. Hei hi TB vei mek enkawl te tan leh mipui tan hriat a pawimawh hle ani. TB enkawlna dan thar chu RNTCP tia vuah ani a, a lampum chu Revised National TB Control Programme tihna a ni.

Kum 1962 atanga 1993 thleng khan India ramah TB veite enkawlna atan National TB Control Programme hi hman alo ni tawh a, damdawi pawh mahni a lei a ngaih bakah mahni kut a damdawi ei a ngai bawk a, enkawl hun chhung pawh kum 1 atanga kum 1 ½ ani tlangpui a, damlo enkawl kha nasa takin a khaihlak phah a ni. Chumi avang chuan India ram pumah kum 1997 atanga tanin TB enkawlna dan thar Revised National TB Control Programme (RNTCP) kan tih mai hi hmanchhoh a lo ni ta a.

 

RNTCP chuan

• 
  
  Sawrkar hotute thawhpui
• 
  
  Microscope hmanga TB vei hmuhchhuah ngei
• 
  
  Mit hmuh lai ngeia damdawi ei tir.
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  Damlo thar puala damdawi dah that
• 
  
  Damlo enkawl na dawng te, a enkawl tawp dan (dampui, thihpui, chhunzawm lo) chhuichhuah dap te a keng tel.

 

RNTCP thil tum chu Khaka TB hrik hmuh 85% chuang tih dam ngei ngei leh Khaka TB hrik hmuh 70% hmuhchhuah ngei a ni a. Chuvang chuan Khak ekzam hi a ngaipawimawh em em a, TB vei finfiahna tha ber chu khak ekzam hi a ni.
TB vei nia rinhlelh tur chi chu chawlhkar hnih emaw a aia rei emaw khuh a, khuh damdawi pangngai an ei pawha sawt lo te hi an ni. TB natna in a kentel te zinga thenkhat, khawsik ser ser leh chaw ei tui lo te chu damloh tirhah a lang nghal vek lova. A tlangpui thuin TB-ah hian khuh pah hian khak pawh a awm deuh zel a. Khak ekzam hi a awlsam em em a, a man a tlawm a, a ekzamtuin a thiama a uluk bawk chuan a rintlak em em mai a, hun rei lo te chhungin a rizal pawh a chhuak nghal mai thin a ni.

 

Khaka TB hrik awm kan hmuh ngei theih nan dik taka ekzam a ngai a, khak aiah chil hnang mai mai te kan ekzam anih chuan TB hrik kan hmu dawn lo a ni.Khak dik tak chhak chhuak tur chuan kut pahniha kawng dawmin sei deuh takin thawk luh tur a ni a, chumi zawh chiahah chuan hrawk chhungril atanga khak tichhuak thei tur zawngin khuh tur a ni. Khuh laiin hma lamah tumah an awm tur a ni lo.TB enkawlna hmun bik emaw, damdawi inah emaw TB vei nia inringhlel a lo kal chuan khak lakna bur chhin nei pek a ni a, chu chu in lamah hawnpuiin a tuk zing thawh hlimah thingpui ilo in hmain khak burah chuan a khak tharlam chu a dah tur a ni a. Chhun lamah chu a khak lak chu a rawn keng ang a, damdawi in a rawn thlen hnuah a khak vawikhat lak leh tur a ni .Tichuan avaiin khak vawi hnih ekzam tur a nih chu. Hetianga khak vawi hnih kher ekzam hi a pawimawh em em a, mithiamte lo zir tawhna atangin hetianga khak vawihnih ekzama a lan dan hi a rintlak tawkah ngaih a ni.

 

TB enkawlna dan tharah chuan TB enkawl hun chhung pawh thla 6 atanga thla 8 a lo ni ta. A thlawna khak ekzam bakah TB vei hmuhchhuah thar apiang chu enkawlna tluantling daih tur damdawi pek nghal zel an ni. TB damdawi hi a to viau laiin sawrkarin damlo hnenah man lovin a pe thin a, a lawmawm khawp mai. TB veite'n anmahni chenna in hnaih thei ang ber atanga damdawi an lam theih turin ruahman a ni a, damlo pakhat tan enkawlna tluantling daih tur damdawi pek zel a ni a, midang tawmpui phal ani lo. Damdawi chu Health Sub-Centre awmna khuaah chuan Health Worker-in a kawl a, chutiang awm lohna khuaah chuan mi rintlak tuin emaw damlo hnenah damdawi chu a pe thin a ni. Chubakah chuan damdawi chu damlo kutah inlama ei atan pe mai lovin a hmuh lai ngeiin a ei tur a ni a, chu chu RNTCP laimu kan tih mai chu DOTS a ni.

 

DOTS lampum chu
Directly Observed Treatment Short Course tihna a ni. A awmzia chu damlo in damdawi pekna hmun (DOT Centre)-ah DOT Provider te mithmuh lai ngeiin damdawi a ei tur a ni. Damlo chuan a inenkawl tan atanga thlahnih a ral hnuah chauh damdawi chu anmahni inlamah a ei phalsak a ni. Hetiang taka damlovin damdawi a ei ngei tih finfiah thlapa enkawlna kan pek hian TB vei, an khaka TB hrik hmuh zinga sawma pakua chuan an dam phah ngei ngei tura ngaih a ni.

DOTS thatna chhan :

India ram pumah DOTS hman anih hma in minute tinin TB vanga thi pakhat zel an awm thin a, DOTS hman anih atangin minute khat leh a chanve chhungin mi 1 zel thi an awm tawh a ni.

DOT Provider te :

TB vei te damdawi petu hi DOT Provider tia koh a ni thin. TB vei chuan Damdawi petu (DOT Provider) te mithmuh lai ngeiin damdawi a eitur a ni a, DOT Provider te hi Health Worker te leh tlawmngaia damdawi petu Voluntary DOT Provider kan tih mai te an ni a. Tlawmngaia damdawi petu te zingah hian zirtirtute, khawtlang hruaitute, ASHA te leh Aganwadi a thawk te pawh an awm. Tunah hian Health Department-a thawktute bakah tlawmngaih chhuaha min thawhpuitute nen TB damdawi petu mi 1013 kan nei mek a ni. TB damdawi eitu leh tlawmngaia damdawi pe tute tan damlovin damdawi a ei zawh hunah Rs.250/- ve ve an dawng thei bawk.

DOT Centre :

DOT Centre chu damlo in damdawi a eina hmun kha a ni. Damlo chenna atanga Sub-Centre emaw Tlawmngaia damdawi petu te in hnai ber kha DOT Centre chu a ni a. Tunah hian damdawi pekna hmun - DOT Centre - 645 lai kan nei mek bawk.

Tunah hian Mizoram pumah TB enkawlna hmun bik District TB Centre (DTC) chu district khawpui zawng zawngah awmin, a puitu tur hmun ruat bik Microscopy Centres 22 chu hmun hrang hrangah dah ani a, TB hmuhchhuah leh enkawlna hmun bik kan neih te chu hetiang hi a ni.

 

District TB Centres	Microscopy Centres
Aizawl District TB Centre	Presbyterian Hospital, Durtlang, Lengpui PHC, Aibawk PHC, Sialsuk PHC, Thingsulthliah PHC, Saitual TB Unit, Darlawn PHC, Sakawrdai PHC, Suangpuilawn CHC
Mamit District TB Centre	Kawrthah CHC, W.Phaileng PHC
Kolasib District TB Centre	Vairengte CHC
Serchhip District TB Centre	N.Vanlaiphai PHC, Thenzawl CHC
Lunglei District TB Centre	Tlabung CHC, Hnahthial CHC, Serkawn Christian Hospital
Lawngtlai District TB Centre	Chawngte CHC
Saiha District TB Centre	Tuipang PHC
Champhai District TB Centre	Khawbung CHC, Ngopa PHC, Khawzawl PHC

 

    Hengah te hian TB hrik hmuhchhuahna nana khak ekzamte a thlawn vekin a tih theih a, damdawi pawh damlo pakhat tan bawm khat zel pek thin ani bawk. RNTCP hian thil pawimawh tak tak panga a keng a, chungte chu hmanraw manto hmang lo va khak ekzam chauha TB finfiah te,TB damdawi tlachham lo tura tam tawk neih reng te, damlovin damdawi a ei ngei a ni tih mit ngeia enpui te,TB enkawlna kawnga hmalakna hrang hrangte hunbi neia vil leh endik reng te, leh heng zawng zawng hlawhtlinna atana sawrkar tumruhna te hi a ni. Heng thil chi hrang hrangte hi pakhat mah thlauhthla lova thahnemngai taka kan bawhzui chauhin he kalphung thar hi a hlawhtling thei dawn a ni.