TB NATNA LEH A ENKAWL TE

-Dr. Gordon Zohmingthanga

State TB Officer

Vawiin 24th March 2010 hi khawvel puma natna tlanglawn leh thihna thlentu lianber te zinga mi - TB natna tibo tura beihpui thlakna ni atan serhhran bik a ni. Kumin kan thupui chu On the move against Tuberculosis innovate to accelerate action - TB natna do turin kan mawhphurhna \heuhah chak takin hma i la ang u tih  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 a\ang khan kan hre ve \an 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. 

Khawvel –

TB natna hi khawvel pumpuiah hian natna tlanglawn leh do hneh loh pathum zinga pakhat ani a, khawvela mihring awm zawng zawng zinga hmunthuma \hena hmunkhat hian TB an vei mek a ni. WHO 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 – 

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 \angkai 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. 

Mizoram -

Mizoramah ngei pawh hian TB vei kan \hahnem ve hle mai a, ni tin TB vei thar 7 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 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 \hen hran ani a. TB vei zawng zawng zingah Chuap TB vei an tam ber. TB vei, an khaka TB hrik hmuh ngeite hi awlsam taka mi dangte kaichhawnga TB semdarh tute an niin hetiang mi, enkawlna dawng lo te chuan kum khatah mi 10-15 vel TB an kaichhawng thei \hin a ni.  Chuap pawnlam TB tia kan sawi theih te chu Ruhah te, Ruh chuktuahah te, \halbeah 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.

Puitling 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. 

A kaichhawn dan -

Chuap TB vei mekin midang a kaichhawn theih dan awlsam ber leh tlanglawn ber chu TB hrik a khuh chhuah a\angin a ni a,a khuh leh hahchhiau leh khak chhak zawngin natna hrik tam tak a paih chhuak \hin 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 \hin 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.  

A enkawl dan – 

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 \anin TB enkawlna dan thar Revised National TB Control Programme (RNTCP) kan tih mai hi hmanchhoh a lo ni ta a. Mizoramah chuan 24th March 2003 a\angin kan hmang ve \an a.

RNTCP chuan 

(1) Sawrkar hotute thawhpui 

(2) Microscope hmanga TB vei hmuhchhuah ngei

(3) Mit hmuh lai ngeia damdawi ei tir.

(4) Damlo thar puala damdawi dah that

(5) 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 Khak ekzam zawng zawng zinga zaa 70 (70%) tal TB hrik 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. 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 \hin a ni.  

TB enkawlna dan tharah chuan TB enkawl hun chhung pawh thla 6 a\anga 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 \hin 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 \awmpui phal ani lo. Damdawi chu Health Sub-Centre awmna khuaah chuan Health Worker-in a kawl a, chutiang awm lohna khuaah chuan mi rintlak (school zirtirtu emaw khawtlang hruaitute) emaw in damlo hnenah damdawi chu an pe \hin 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 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 :

DOTS hi tunah hian khawvel ram 180 laiin kan hmang mek a.  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 \hin.  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

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 \hin 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.

Tunah hian TB enkawlna dawng tawh, a hunbi kim hmaa mahni thua bansan ta mai te, an damdawi ei \hatphaha in hriat vang emaw, \hatpui 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 \hahnem tak an awm mek  a ni. Hei hian natna tihdam har tak leh enkawlna hau tak em em mai MDR (Multi Drug Resistance) a thlen thei a ni. Hetiang hi tunah hian Mizoramah pawh mi 200 chuang vel lai damlo kan nei tawh a. Chuvang chuan damlo ten \ha taka damdawi kan ei a pawimawh a, a enkawl tuten inthlahdah hauh lova kan enkawl a pawimawh bawk a. 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 \an tlan a pawimawh em em a ni.