Kifua kikuu : Tofauti kati ya masahihisho
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== kifua kikuu Sioonekana==
[[File:Mantoux tuberculin skin test .jpg thumb|[[Mantoux test|Mantoux tuberculin skin test]]]] [[Mantoux mithani |Mantoux tuberculin ngozi mithani mara nyingi hutumika kwa watu screen katika hatari kubwa ya TB.<ref name=Clinic2009/> Wale ambao wamekuwa awali chanjo wanaweza kuwa na uongo chanya mtihani matokeo.<ref name=Rothel_2005>{{cite journal author=Rothel J, Andersen P |title=Diagnosis of latent ''Mycobacterium tuberculosis'' infection: is the demise of the Mantoux test imminent?|journal=Expert Rev Anti Infect Ther |volume=3 |issue=6 |pages=981–93 |year=2005|pmid = 16307510|doi = 10.1586/14787210.3.6.981}}</ref>mtihani inaweza kuwa uongo hasi katika wale walio na [[sarcoidosis]], [[Hodgkin's lymphoma]], na [[utapiamlo]]. au wengi hasa, katika wale ambao kweli kufanya wana kifua kikuu hai. <ref name=Robbins/> [[Interferon assays katika vivuli mbalimbali ya njano lioenea, kuashiria juu ya watu 300 kwa kila 100,000, na kwa Marekani, Canada, Australia, na Ulaya ya kaskazini katika vivuli ya bluu kirefu, kuashiria kiwango cha maambukizi karibu 10 kwa kila watu 100,000. Asia ni njano lakini si hivyo kabisa mkali, kuashiria kiwango cha maambukizi ya kuzunguka 200 per mbalimbali 100,000. Amerika ya Kusini ni ya njano nyeusi. Mwaka 2007, kiwango cha maambukizi ya TB kwa watu 100,000 ilikuwa ya juu katika Afrika Kusini mwa Sahara, na pia alikuwa kiasi katika Asia. >{{cite book |title=Global tuberculosis control: epidemiology, strategy, financing |author=World Health Organization |year=2009 |isbn=978-92-4-156380-2|chapter=The Stop TB Strategy, case reports, treatment outcomes and estimates of TB burden|chapterurl=http://who.int/tb/publications/global_report/2009/annex_3/en/index.html|accessdate=14 November 2009|pages=187–300}}</ref>[[ kutolewa gamma ]] (IGRAs) juu ya sampuli ya damu, ni ilipendekeza kwa wale ambao ni chanya kwa mtihani Mantoux.<refname=NICE2011>{{NICE|117|Tuberculosis|2011}}</ref> IGRAs Haya si walioathirika na chanjo au zaidi [[mazingira mycobacteria]], hivyo wao kuzalisha wachache [[matokeo ya uongo]] na HIV. <ref>{{cite journal|author=Pai M, Zwerling A, Menzies D|title=Systematic Review: T-Cell–based Assays for the Diagnosis of Latent Tuberculosis Infection: An Update |journal=Ann. Intern. Med. |volume=149 |issue=3 |pages=1–9 |year=2008 |pmid=18593687 |pmc=2951987}} </ref> hivyo wao kuzalisha wachache matokeo ya uongo na HIV. Hata hivyo wao walioathirika na M. szulgai, M. marinum na M. kansasii.”<ref>{{cite book|last=Jindal|first=editor-in-chief SK|title=Textbook of pulmonary and critical care medicine|publisher=Jaypee Brothers Medical Publishers|location=New Delhi|isbn=978-93-5025-073-0|pages=544|url=http://books.google.ca/books?id=rAT1bdnDakAC&pg=PA544}}</ref> IGRAs inaweza kuongeza usikivu wakati kutumika kwa kuongeza mtihani ngozi lakini inaweza kuwa chini zaidi kuliko mtihani nyeti ngozi wakati kutumika peke yake.<ref>{{cite journal|last=Amicosante|first=M|coauthors=Ciccozzi, M, Markova, R|title=Rational use of immunodiagnostic tools for tuberculosis infection: guidelines and cost effectiveness studies.|journal=The new microbiologica|date=2010Apr|volume=33|issue=2|pages=93107|pmid=205181}}</ref>.
=== Kuzuia ===
Kuzuia ya Kifua Kikuu na kudhibiti juhudi kimsingi wanategemea chanjo ya watoto wachanga na kugundua na matibabu sahihi ya matukio hai. <ref name=Lancet11/> [[Shirika la Afya Duniani]] (WHO) imepata baadhi ya mafanikio mazoezi kuboresha tiba, na kupungua kwa idadi ndogo ya kesi. <ref name=Lancet11/>
==Chanjo==
[[Chanjo]] tu sasa inapatikana kama ya 2011 ni [[bacillus Calmette-Guérin|bacillus Calmette– Guérin]] (BCG). Ambayo, wakati ni ufanisi dhidi ya ugonjwa kusambazwa katika utoto, unampa ulinzi dhidi ya kuambukizwa TB haiendani mapafu. <ref>{{cite journal|last=McShane|first=H|title=Tuberculosis vaccines: beyond bacille Calmette–Guérin|journal=Philosophical transactions of the Royal Society of London. Series B, Biological sciences|date=12 October 2011|volume=366|issue=1579|pages=27829|pmid=21893541|doi=10.1098/rstb.2011.0097|pmc=3146779}}</ref> Hata hivyo, ni wengi sana kutumika chanjo duniani kote, na zaidi ya 90% ya watoto wote kuwa [[chanjo]]. <ref name=Lancet11/>Hata hivyo, kinga ni kuvuta itapungua baada ya miaka kumi.<ref name=Lancet11/> Kama kifua kikuu ni kawaida katika zaidi ya Canada, Uingereza, na Marekani, BCG ni tu unasimamiwa na watu katika hatari ya juu. <ref>{{cite web|url=http://www.cdc.gov/tb/topic/vaccines/|title=Vaccine and Immunizations: TB Vaccine (BCG)|publisher =Centers for Disease Control and Prevention|year=2011|accessdate=26 July 2011}}</ref><ref>{{cite web|title=BCG Vaccine Usage in Canada -Current and Historical|url=http://www.phacaspc.gc.ca/tbpclatb/bcgvac_120eng.php|work=Public Health Agency of Canada|accessdate=30 December 2011|year=2010|month=September}}</ref><ref name=UK06>{{cite journal|last=Teo|first=SS|coauthors=Shingadia, DV|title=Does BCG have a role in tuberculosis control and prevention in the United Kingdom?|journal=Archives of Disease in Childhood|date=2006 Jun|volume=91|issue=6|pages=529–31|pmid=16714729|pmc= 2082765|doi=10.1136/adc.2005.085043 }}</ref> Sehemu ya hoja akisema dhidi ya matumizi ya chanjo ni kwamba inafanya [[ ngozi tuberculin mtihani ]] uongo chanya, na kwa hiyo, hakuna wa matumizi katika uchunguzi.<ref name=UK06/> idadi ya chanjo mpya ni sasa katika maendeleo<ref name=Lancet11/>
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