Kifua kikuu : Tofauti kati ya masahihisho

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'''Kifua kikuu''' (kwa [[ing.Kiingereza]] ''tuberculosis'', kifupi '''TB''') ni [[ugonjwa wa kuambukizwa]] ulio hatari. [[Ugonjwa]] huu husababishwa na aina mbalimbali za [[bakteria]], pia ambazo hujulikana kama '' [[Mycobacterium tuberculosis]]''.<ref name=Robbins>{{cite book |author=Kumar V, Abbas AK, Fausto N, Mitchell RN |year=2007 |title=Robbins Basic Pathology |edition=8th |publisher=Saunders Elsevier |pages=516–522 |isbn=978-1-4160-2973-1}}</ref> Kifua kikuu kwa kawaida kinaathiri [[mapafu]], lakini pia kinaweza kuathiri sehemu nyingine za mwili.
 
Kifua kikuu kwa kawaida kinaathiri [[mapafu]], lakini pia kinaweza kuathiri sehemu nyingine za [[mwili]].
Kifua Kikuu nihusambazwa kutoka kwa mtu mmoja hadi mwingine kwa kupitia hewa wakati anapokoa, kupiga chafya, au mate yake yakiwa hewani AP <ref name="AP">{{cite journal|author=Konstantinos A |year=2010|title=Testing for tuberculosis |journal=Australian Prescriber |volume= 33 |issue=1|pages=12–18 |url= http://www.australianprescriber.com/magazine/33/1/12/18/}}</ref> Maambukizi mengi hayana dalili hayaleti madhara. Lakini moja kati ya kumi ya maambukizo yasiyoleta madhara hatimaye huendelea na kuwa ugonjwa kamili. Kama kifua kikuu kisipotibiwa, kinaua zaidi ya 50% ya watu walioambukizwa.
 
Kifua Kikuukikuu nihusambazwahusambazwa kutoka kwa [[mtu]] mmoja hadi mwingine kwa kupitia [[hewa]] wakati anapokoaanapokohoa, kupiga chafya, au [[mate]] yake yakiwa hewani AP <ref name="AP">{{cite journal|author=Konstantinos A |year=2010|title=Testing for tuberculosis |journal=Australian Prescriber |volume= 33 |issue=1|pages=12–18 |url= http://www.australianprescriber.com/magazine/33/1/12/18/}}</ref> Maambukizi mengi hayana dalili hayaleti madhara. Lakini moja kati ya kumi ya maambukizo yasiyoleta madhara hatimaye huendelea na kuwa ugonjwa kamili. Kama kifua kikuu kisipotibiwa, kinaua zaidi ya 50% ya watu walioambukizwa.
Dalili za kawaida za maambukizi ya kifua kikuu kinacholeta madhara ni [[kikohozi|kikohozi sugu]] na [[Hemoptysis|kukohoa damu]], [[Kohozi]], [[homa]], [[kutokwa na jasho usiku]], na [[kukonda]]. (Kifua kikuu kilikuwa kinaitwa "matumizi" kwa sababu watu walioambukizwa hupunguza uzito.) Maambukizi ya viungo vingine husababisha dalili mbalimbali. [[Njia ya kiutaalamu ya utambuzi|utambuzi]] wa kifua kikuu kwa kutumia eksirei ya kuchunguza ugonjwa hujulikana kama eksirei ya kifua na pia wanatumia maikroskopi} na kufanya uchunguzi wa [[vimelea maradhi]] vya majimaji ya mwilini. Uchunguzi wa kifua kikuu kisicholeta madhara hutumia kipimo kiitwacho [[Mantoux test|tuberculin skin test au kipimo cha ngozi]] (TST) na vipimo vya damu. [[Matibabu ya kifua kikuu|tiba]] si rahisi na inabidi kupewa dawa nyingi za kinga mwili kwa kipindi kirefu. Mawasiliano ya kijamii pia yanapimwa na kutibiwa kama inavyotakiwa. [[Dawa kushindwa kutibu magonjwa]] ni tatizo kubwa la maambukizi [[mbalimbali sugu ya kifua kikuu|mengi sugu ya kifua kikuu]] (MDR-TB). Ili kuzuia kifua kikuu, ni lazima watu wapimwe ugonjwa na [[wachanjwe]] na chanjo ya [[Bacillus Calmette-Guérin|bacillus Calmette - Guérin]] .
 
Maambukizi mengi hayana [[dalili]] wala hayaleti madhara. Lakini [[moja]] kati ya maambukizo kumi yasiyoleta madhara hatimaye huendelea na kuwa ugonjwa kamili. Kama kifua kikuu kisipotibiwa, kinaua zaidi ya 50[[%]] ya watu walioambukizwa.
Wataalamu wanaamini kwamba theluthi moja ya [[Idadi ya watu duniani]] wameambukizwa'' kifua kikuu'', <ref name=WHO2012data>{{cite web|url=http://www.who.int/mediacentre/factsheets/fs104/en/index.html|title=Tuberculosis Fact sheet N°104|publisher=[[World Health Organization]]|date=November 2010|accessdate=26 July 2011}}</ref> na kila sekunde kuna mtu ambaye anaambukizwa <ref name= WHO2012data /> Mwaka 2007, kadri ya watu 13,700,000 duniani waliambukizwa na kifua kikuu kinacholeta madhara sugu <ref name= WHO2009 -Epidemiology> {{cite book |title=Global tuberculosis control: epidemiology, strategy, financing |author=World Health Organization |year=2009 |isbn=978-92-4-156380-2|chapter=Epidemiology|chapterurl=http://who.int/entity/tb/publications/global_report/2009/pdf/chapter1.pdf |accessdate=12 November 2009 |pages=6–33}}</ref> Mwaka 2010, kadri ya milioni 8.8 ya watu waliambukizwa na milioni 1.5 ya watu walifariki baada ya kuambukizwa na kifua kikuu, na wagonjwa wengi wanapatikana katika [[nchi zinazoendelea|nchi zinazoendelea.]] <ref name=WHO2011>{{cite web|title=The sixteenth global report on tuberculosis|author=World Health Organization|url=http://www.who.int/tb/publications/global_report/2011/gtbr11_executive_summary.pdf|year=2011}}</ref> Idadi halisi ya wagonjwa wa kifua kikuu imekuwa ikipungua tangu mwaka 2006, na kesi mpya zimeshuka tangu mwaka 2002.<ref name=WHO2011/> Kifua kikuu sio ugonjwa unaosambazwa kisawasawa duniani kote. Kadri ya 80% ya watu katika nchi nyingi za Asia na Afrika waliofanyiwa kipimo cha ngozi walionekana wameambukizwa, lakini ni asilimia 5-10% tu ya wananchi wa Marekani ambao walionekana na ugonjwa huo.<ref name= Robbins/> Watu wengi waliopo katika [[nchi zilizoendelea|zinazoendelea duniani]] wanaambukizwa na kifua kikuu kwa sababu ya kutokuwa na kinga. Kwa kawaida, hawa watu wanaambukizwa na kifua kikuu baada ya kuambukizwa na [[VVU]] na hatimaye wanapatwa na [[UKIMWI]].<ref name=Lancet11/>
 
Dalili za kawaida za maambukizi ya kifua kikuu kinacholeta madhara ni [[kikohozi|kikohozi sugu]] na [[Hemoptysis|kukohoa damu]], [[Kohozi]], [[homa]], [[kutokwa na jasho usiku]], na [[kukonda]]. (Kifua kikuu kilikuwa kinaitwa "matumizi" kwa sababu watu walioambukizwa hupunguza uzito.) Maambukizi ya viungo vingine husababisha dalili mbalimbali. [[Njia ya kiutaalamukitaalamu ya utambuzi|utambuzi]] wa kifua kikuu kwa kutumia [[eksirei]] ya kuchunguza ugonjwa hujulikana kama eksirei ya kifua na pia wanatumia maikroskopi}[[hadubini]] na kufanya uchunguzi wa [[vimelea maradhi]] vya [[majimaji]] ya mwilini. Uchunguzi wa kifua kikuu kisicholeta madhara hutumia kipimo kiitwacho [[Mantoux test|tuberculin skin test au kipimo cha ngozi]] (TST) na vipimo vya damu. [[Matibabu ya kifua kikuu|tiba]] si rahisi na inabidi kupewa dawa nyingi za kinga mwili kwa kipindi kirefu. Mawasiliano ya kijamii pia yanapimwa na kutibiwa kama inavyotakiwa. [[Dawa kushindwa kutibu magonjwa]] ni tatizo kubwa la maambukizi [[mbalimbali sugu ya kifua kikuu|mengi sugu ya kifua kikuu]] (MDR-TB). Ili kuzuia kifua kikuu, ni lazima watu wapimwe ugonjwa na [[wachanjwe]] na chanjo ya [[Bacillus Calmette-Guérin|bacillus Calmette - Guérin]] .
 
[[Matibabu ya kifua kikuu|tiba]] si rahisi na inabidi kupewa dawa nyingi za kinga mwili kwa kipindi kirefu. Mawasiliano ya kijamii pia yanapimwa na kutibiwa kama inavyotakiwa. [[Dawa zinazoshindwa kutibu magonjwa]] ni tatizo kubwa la maambukizi sugu mengi ya kifua kikuu]] (MDR-TB).
 
Ili kuzuia kifua kikuu, ni lazima watu wapimwe ugonjwa na wapate [[chanjo]] ya [[Bacillus Calmette-Guérin|bacillus Calmette - Guérin]].
 
[[Wataalamu]] wanaamini kwamba [[theluthi]] moja ya [[Idadiidadi]] ya watu [[duniani]] wameambukizwa''waliambukizwa kifua kikuu'', <ref name=WHO2012data>{{cite web|url=http://www.who.int/mediacentre/factsheets/fs104/en/index.html|title=Tuberculosis Fact sheet N°104|publisher=[[World Health Organization]]|date=November 2010|accessdate=26 July 2011}}</ref> na kila [[sekunde]] kuna mtu ambaye anaambukizwa <ref name= WHO2012data />. Mwaka [[2007]], kadri ya watu 13,700,000 duniani waliambukizwa na kifua kikuu kinacholeta madhara sugu <ref name= WHO2009 -Epidemiology> {{cite book |title=Global tuberculosis control: epidemiology, strategy, financing |author=World Health Organization |year=2009 |isbn=978-92-4-156380-2|chapter=Epidemiology|chapterurl=http://who.int/entity/tb/publications/global_report/2009/pdf/chapter1.pdf |accessdate=12 November 2009 |pages=6–33}}</ref> Mwaka [[2010]], kadri ya milioni 8.8 ya watu waliambukizwa na milioni 1.5 ya watu walifariki baada ya kuambukizwa na kifua kikuu, na wagonjwa wengi wanapatikana katika [[nchi zinazoendelea|nchi zinazoendelea.]] .<ref name=WHO2011>{{cite web|title=The sixteenth global report on tuberculosis|author=World Health Organization|url=http://www.who.int/tb/publications/global_report/2011/gtbr11_executive_summary.pdf|year=2011}}</ref> Idadi halisi ya wagonjwa wa kifua kikuu imekuwa ikipungua tangu mwaka [[2006]], na kesi mpya zimeshuka tangu mwaka [[2002]].<ref name=WHO2011/> Kifua kikuu sio ugonjwa unaosambazwa kisawasawa duniani kote. Kadri ya 80% ya watu katika nchi nyingi za Asia na Afrika waliofanyiwa kipimo cha ngozi walionekana wameambukizwa, lakini ni asilimia 5-10% tu ya wananchi wa Marekani ambao walionekana na ugonjwa huo.<ref name= Robbins/> Watu wengi waliopo katika [[nchi zilizoendelea|zinazoendelea duniani]] wanaambukizwa na kifua kikuu kwa sababu ya kutokuwa na kinga. Kwa kawaida, hawa watu wanaambukizwa na kifua kikuu baada ya kuambukizwa na [[VVU]] na hatimaye wanapatwa na [[UKIMWI]].<ref name=Lancet11/>
 
Kifua kikuu si ugonjwa unaosambazwa sawasawa duniani kote. Kadri ya 80% ya watu katika nchi nyingi za [[Asia]] na [[Afrika]] waliofanyiwa kipimo cha ngozi walionekana wameambukizwa, lakini ni asilimia 5-10% tu ya wananchi wa [[Marekani]] ambao walionekana na ugonjwa huo.<ref name= Robbins/> Watu wengi waliopo katika [[nchi zilizoendelea]] wanaambukizwa kifua kikuu kwa sababu ya kutokuwa na kinga. Kwa kawaida, hawa watu wanaambukizwa kifua kikuu baada ya kuambukizwa na [[VVU]] na hatimaye wanapatwa na [[UKIMWI]].<ref name=Lancet11/>
 
== Dalili na ishara ==
[[Picha:Tuberculosis symptoms.svg| thumb | Dalili kuu na ishara tofauti pamoja na hatua za kifua kikuu zinajulikana <ref>{{cite web|url=http://www.emedicinehealth.com/tuberculosis/page3_em.htm|title=Tuberculosis Symptoms|publisher=[[eMedicine]]Health|author=Schiffman G|date=15 January 2009}}</ref> Dalili nyingi huchanganyika na ishara zingine, ingawa kuna dalili zingine ambazo (ingawa sio lazima) ni za aina fulani ya kifua kikuu. Aina mbalimbali za kifua kikuu zinaweza kuwepo kwa pamoja.]]
 
Kuna kadri ya 5-10% ya watu ambao hawana VVU ingawa wameambukizwa na kifua kikuu na wanapatwa na madhara katika maisha yao .<ref name=Pet2005>{{Cite book|author=edited by Peter G. Gibson ; section editors, Michael Abramson ... ''et al.''|title=Evidence-based respiratory medicine|year=2005|publisher=Blackwell|location=Oxford|isbn=978-0-7279-1605-1|pages=321|url=http://books.google.ca/books?id=sDIKJ1s9wEQC&pg=PA321|edition=1. publ.}}</ref> Kwa upande mwingine, 30% ya watu ambao wameambukizwa na VVU pamoja na kifua kikuu, huwa wanapatwa na madhara ya ugonjwa huo <ref name= Pet2005 /> Kifua Kikuukikuu kinaweza kuambukiza sehemu yoyote ya mwili, lakini kwa kawaida hutokea katika mapafu (na inajulikana kama kifua kikuu cha mapafu) .<ref. name= ID10 /> TB Extrapulmonary ni kifua kikuu kinachotokea sehemu yoyote ya mwili yaani nje ya mapafu. TBHicho Extrapulmonary inawezakinaweza pia kuwepo pamoja na kifua kikuu cha mapafu <ref. Name= ID10 /> Ishara na dalili ni pamoja na [[homa]], [[Homa ya (dawa)|baridi]], [[Kutokwakutokwa na jasho usiku]], [[Hamu hasara|kupoteza hamu ya kula]], [[kukonda]] , na [[uchovu (matibabu)|uchovu.]] .<ref Name= ID10 /> Kuna uwezekano mkubwa wa [[kujikunja kwa kucha pembeni]] .<ref. Name= Pet2005 />
 
=== Mapafu ===
Kifua kikuu kikiambukiza kinaathiri mapafu kwa 90% ya wagonjwa <ref name= Lancet11/> <ref>{{cite book|last=Behera|first=D.|title=Textbook of pulmonary medicine|year=2010|publisher=Jaypee Brothers Medical Pub.|location=New Delhi|isbn=978-81-8448-749-7|pages=457|url=http://books.google.ca/books?id=0TbJjd9eTp0C&pg=PA457|edition=2nd ed.}}</ref> Dalili zake huweza kuwa [[maumivu ya kifua]] na kikohozi cha muda mrefu chenye makohozi.<ref Name=Lancet11/> Kadri ya 25% ya watu hawana dalili yoyote (yaani, wao hawaonyeshi "dalili") <ref name= Lancet11/> Wakati mwingine, wagonjwa. [[Hemoptysis|wanakohoa damu]] kwa kiasi kidogo. Wakati mwingine, ugonjwa unaweza kusababisha [[mshipa wa mapafu]] imomonyoke, na kusababisha damu nyingi kuvuja hali hii inaitwa [[Rasmussen's aneurysm]].<ref name=ID10/> Kifua kikuu kinaweza kusababishwa na vimelea sugu na kusababisha makovu katika masikio ya juu ya mapafu.<ref Name=ID10/>. Mara nyingi ni mapafu ya juu yanayoathirika <ref name=ID10/> Sababu haijulikani vizuri <ref name=" Robbins "/> Labda mapafu ya juu yanaathirika zaidi kwa sababu yanapata hewa kwa njia bora <ref name=" Robbins "/> au kwa sababu ya ukaushaji mbaya wa [[limfu]].<ref Name= ID10 />
 
=== Kifua kikuu katika sehemu nyingine ya mwili ===
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== Visababishi ==
=== Mycobacteria ===
[[Picha: Mycobacterium tuberculosis.jpg | thumb | [[Skanning elektroni mikrografu]] ya '' [[Mycobacterium tuberculosis ]]'']]
IKisababishiKisababishi kikubwa cha kifua kikuu ni '' [[Mycobacterium tuberculosis]]'', ni kiumbe kidogo, kinachohitaji [[kinachohitaji oksijeni]] na kisichotembea [[bacillus]]<ref name=ID10>{{cite book|author=[edited by] Gerald L. Mandell, John E. Bennett, Raphael Dolin|title=Mandell, Douglas, and Bennett's principles and practice of infectious diseases|year=2010|publisher=Churchill Livingstone/Elsevier|location=Philadelphia, PA|isbn=978-0-443-06839-3|pages=Chapter 250|edition=7th}}</ref> Sifa nyingi za kipekeepekee za kiumbe hiki zinaletwa na ongezeko kubwa la [[mafuta]] <ref>{{cite book|author=Southwick F |title=Infectious Diseases: A Clinical Short Course, 2nd ed. |publisher=McGraw-Hill Medical Publishing Division |date=10 December 2007 |pages=313–4 |chapter=Chapter 4: Pulmonary Infections |page=104|url=http://pharma-books.blogspot.com/2009/01/infectious-disease-clinical-short.html |isbn=0-07-147722-5|archiveurl=http://archive.is/rSN4|archivedate=13 July 2012}}</ref> Ina [[seli]] inayojigawa kila baada ya masaasaa 16 hadi 20. Kiwango hiki si kikubwa ukilinganishwa na bakteria zinginenyingine, ambazo kwa kawaida vinajigawa kwa muda usiopungua saa mmoja <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=525|url=http://books.google.ca/books?id=rAT1bdnDakAC&pg=PA525}}</ref> Mycobacteria wana [[muundo wa seli ya bakteria|utando wa nje]] utando wa mafuta <ref name=Niederweis2010>{{cite journal |author=Niederweis M, Danilchanka O, Huff J, Hoffmann C, Engelhardt H |title=Mycobacterial outer membranes: in search of proteins |journal=Trends in Microbiology |volume=18 |issue=3 |pages=109–16 |year=2010 |month=March |pmid=20060722 |pmc=2931330|doi=10.1016/j.tim.2009.12.005}}</ref> Kama jaribio la [[Gramu stain]] likifanywa, MTB haikolei sana rangi yaani "Gram-positive" haipatikani na rangi haionekani kwa sababu utando wake una mafuta mengi [[mafuta]] pamoja na asidi [[Mycolic acid]].<ref name=Madison_2001>{{cite journal |author=Madison B |title=Application of stains in clinical microbiology |journal=Biotech Histochem |volume=76 |issue=3 |pages=119–25 |year=2001 |pmid=11475314 |doi=10.1080/714028138}}</ref> MTB inaweza kuhimili kemikali [[dhaifu]] na hivi vimelea vinaweza kuishi katika [[kijimbegu au|sehemu kavu]] kwa wiki moja. Kwa kawaida, bakteria zinaweza kukua na kuishi tu ndani ya seli ya [[kiumbe (biolojia)|kiumbe]] viumbe, lakini'' M. tuberculosis' inaweza kukuzwa [[ndani in vitro|ya maabara]].<ref name=Parish_1999>{{cite journal |author=Parish T, Stoker N |title=Mycobacteria: bugs and bugbears (two steps forward and one step back) |journal=Molecular Biotechnology |volume=13 |issue=3 |pages=191–200 |year=1999| pmid=10934532 |doi = 10.1385/MB:13:3:191}}</ref>
 
Kwa kutumia vipimo vya kimaabara vya kansa [[Histology|histological]] kwa kuweka madoa juu ya sampuli ya [[mate]] yaliyotoka kwenye [[makohozi]], wanasayansi wanaweza kutambua MTB chini ya makroskopi (nyepesi) ya kawaida. (Phlegm pia inaitwa "kohozi.") MTB huacha madoa hata baada ya kuchanganywa na asidi, na hivyo hujulikana kama [[Acid-fast bacillus]] (AFB)<ref name= Robbins/><ref name="Madison_2001"/> acid-fast bacillus. Kuna njia mbili zinazotumia vipimo vya asidi :. Kipimo kinachojulikana kama [[Ziehl - Neelsen stain]], kinageuza rangi ya vimelea AFB na kuwa vyekundu na vinaonekana wazi wazi dhidi ya sehemu ya bluu,<ref name=Stain2000>{{cite book |author= |title=Medical Laboratory Science: Theory and Practice|publisher=Tata McGraw-Hill |location=New Delhi |year=2000 |pages=473 |isbn=0-07-463223-X|url=http://books.google.ca/books?id=lciNs3VQPLoC&pg=PA473}}</ref> na [[auramine-rhodamine stain]] ambayo hufuatiwa na makroskopi yenye kuakisi mwanga.<ref>{{cite book|last=Piot|first=editors, Richard D. Semba, Martin W. Bloem; foreword by Peter|title=Nutrition and health in developing countries|year=2008|publisher=Humana Press|location=Totowa, NJ|isbn=978-1-934115-24-4|pages=291|url=http://books.google.ca/books?id=RhH6uSQy7a4C&pg=PA291|edition=2nd ed.}}</ref>
IKisababishi kikubwa cha kifua kikuu ni '' [[Mycobacterium tuberculosis]]'', ni kiumbe kidogo, [[kinachohitaji oksijeni]] na kisichotembea [[bacillus]]<ref name=ID10>{{cite book|author=[edited by] Gerald L. Mandell, John E. Bennett, Raphael Dolin|title=Mandell, Douglas, and Bennett's principles and practice of infectious diseases|year=2010|publisher=Churchill Livingstone/Elsevier|location=Philadelphia, PA|isbn=978-0-443-06839-3|pages=Chapter 250|edition=7th}}</ref> Sifa nyingi za kipekee za kiumbe hiki zinaletwa na ongezeko kubwa la [[mafuta]] <ref>{{cite book|author=Southwick F |title=Infectious Diseases: A Clinical Short Course, 2nd ed. |publisher=McGraw-Hill Medical Publishing Division |date=10 December 2007 |pages=313–4 |chapter=Chapter 4: Pulmonary Infections |page=104|url=http://pharma-books.blogspot.com/2009/01/infectious-disease-clinical-short.html |isbn=0-07-147722-5|archiveurl=http://archive.is/rSN4|archivedate=13 July 2012}}</ref> Ina seli inayojigawa kila baada ya masaa 16 hadi 20. Kiwango hiki si kikubwa ukilinganishwa na bakteria zingine, ambazo kwa kawaida vinajigawa kwa muda usiopungua saa mmoja <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=525|url=http://books.google.ca/books?id=rAT1bdnDakAC&pg=PA525}}</ref> Mycobacteria wana [[muundo wa seli ya bakteria|utando wa nje]] utando wa mafuta <ref name=Niederweis2010>{{cite journal |author=Niederweis M, Danilchanka O, Huff J, Hoffmann C, Engelhardt H |title=Mycobacterial outer membranes: in search of proteins |journal=Trends in Microbiology |volume=18 |issue=3 |pages=109–16 |year=2010 |month=March |pmid=20060722 |pmc=2931330|doi=10.1016/j.tim.2009.12.005}}</ref> Kama jaribio la [[Gramu stain]] likifanywa, MTB haikolei sana rangi yaani "Gram-positive" haipatikani na rangi haionekani kwa sababu utando wake una mafuta mengi [[mafuta]] pamoja na asidi [[Mycolic acid]].<ref name=Madison_2001>{{cite journal |author=Madison B |title=Application of stains in clinical microbiology |journal=Biotech Histochem |volume=76 |issue=3 |pages=119–25 |year=2001 |pmid=11475314 |doi=10.1080/714028138}}</ref> MTB inaweza kuhimili kemikali [[dhaifu]] na hivi vimelea vinaweza kuishi katika [[kijimbegu au|sehemu kavu]] kwa wiki moja. Kwa kawaida, bakteria zinaweza kukua na kuishi tu ndani ya seli ya [[kiumbe (biolojia)|kiumbe]] viumbe, lakini'' M. tuberculosis' inaweza kukuzwa [[ndani in vitro|ya maabara]].<ref name=Parish_1999>{{cite journal |author=Parish T, Stoker N |title=Mycobacteria: bugs and bugbears (two steps forward and one step back) |journal=Molecular Biotechnology |volume=13 |issue=3 |pages=191–200 |year=1999| pmid=10934532 |doi = 10.1385/MB:13:3:191}}</ref>
 
Mchangamano wa “M. tuberculosis'' (MTBC) ni pamoja na bakteria zinginenyingine nne zinazosababisha kifua kikuu {[[mycobacterium|mycobacteria]]: “[[Mycobacterium bovis|M. bovis]],” “[[Mycobacterium africanum|M. africanum]],” “[[Mycobacterium canetti|M. canetti]],” pamoja na “[[Mycobacterium microti|M. microti]].”<ref>{{cite journal|author=van Soolingen D |title=A novel pathogenic taxon of the Mycobacterium tuberculosis complex, Canetti: characterization of an exceptional isolate from Africa |journal=International Journal of Systematic Bacteriology |volume=47 |issue=4 |pages=1236–45 |year=1997 |pmid=9336935|doi=10.1099/00207713-47-4-1236 |author-separator=, |display-authors=1 |last2=Hoogenboezem |first2=T. |last3=De Haas|first3=P. E. W. |last4=Hermans |first4=P. W. M. |last5=Koedam |first5=M. A. |last6=Teppema |first6=K. S. |last7=Brennan|first7=P. J. |last8=Besra |first8=G. S. |last9=Portaels |first9=F.}}</ref> “M. africanum” haijasambaa sana, lakini ndio kisababishi kikubwa cha kifua kikuu katika maeneo ya Afrika <ref>{{cite journal |author=Niemann S |title=Mycobacterium africanum Subtype II Is Associated with Two Distinct Genotypes and Is a Major Cause of Human Tuberculosis in Kampala, Uganda|journal=J. Clin. Microbiol. |volume=40 |issue=9 |pages=3398–405 |year=2002 |pmid=12202584 |pmc=130701|doi=10.1128/JCM.40.9.3398-3405.2002 |author-separator=, |display-authors=1 |last2=Rusch-Gerdes |first2=S. |last3=Joloba|first3=M. L. |last4=Whalen |first4=C. C. |last5=Guwatudde |first5=D. |last6=Ellner |first6=J. J. |last7=Eisenach|first7=K. |last8=Fumokong |first8=N. |last9=Johnson |first9=J. L.}}</ref><ref>{{cite journal |author=Niobe-Eyangoh SN|title=Genetic Biodiversity of Mycobacterium tuberculosis Complex Strains from Patients with Pulmonary Tuberculosis in Cameroon |journal=J. Clin. Microbiol. |volume=41 |issue=6 |pages=2547–53 |year=2003 |pmid=12791879 |pmc=156567|doi=10.1128/JCM.41.6.2547-2553.2003 |author-separator=, |display-authors=1 |last2=Kuaban |first2=C. |last3=Sorlin|first3=P. |last4=Cunin |first4=P. |last5=Thonnon |first5=J. |last6=Sola |first6=C. |last7=Rastogi |first7=N.|last8=Vincent |first8=V. |last9=Gutierrez |first9=M. C.}}</ref> “M. bovis” ndio ilikuwa ni kisababishi kikubwa cha kifua kikuu, lakini baada ya kuanza kutumia [[pasteurisation|maziwa yanayopashwa moto]] vimelea vya mycobacterium vimeweza kuondolewa na kupuguza matatizo ya kiafya katika nchi zinazoendelea.<ref name=Robbins/><ref>{{cite journal |author=Thoen C, Lobue P, de Kantor I |title=The importance of''Mycobacterium bovis'' as a zoonosis |journal=Vet. Microbiol.</ref> "M. Canetti " ni adimu sana na huonekana zaidi [[Eneo la Pembezoni mwa Afrika]], ingawa kuna wagonjwa wachache kati ya wahamiaji wanaotoka Afrika. <ref>{{cite book|last=Acton|first=Q. Ashton|title=Mycobacterium Infections: New Insights for the Healthcare Professional|year=2011|publisher=ScholarlyEditions|isbn=978-1-4649-0122-5|pages=1968|url=http://books.google.ca/books?id=g2iFfV6uEuAC&pg=PA1968}}</ref><ref>{{cite journal|last=Pfyffer|first=GE|coauthors=Auckenthaler, R, van Embden, JD, van Soolingen, D|title=Mycobacterium canettii, the smooth variant of M. tuberculosis, isolated from a Swiss patient exposed in Africa.|journal=Emerging infectious diseases|date=1998 Oct-Dec|volume=4|issue=4|pages=631-4|pmid=9866740}}</ref> "M. microti" pia ni adimu na inawaathiri zaidi watu wenye upungufu wa kingamwili, ingawa ugonjwa huu unaweza kuwa umeenea zaidi kuliko inavyofikiriwa<ref>{{cite journal|last=Panteix|first=G|coauthors=Gutierrez, MC, Boschiroli, ML, Rouviere, M, Plaidy, A, Pressac, D, Porcheret, H, Chyderiotis, G, Ponsada, M, Van Oortegem, K, Salloum, S, Cabuzel, S, Bañuls, AL, Van de Perre, P, Godreuil, S|title=Pulmonary tuberculosis due to Mycobacterium microti: a study of six recent cases in France.|journal=Journal of medical microbiology|date=2010 Aug|volume=59|issue=Pt 8|pages=984-9|pmid=20488936}}</ref>
Kwa kutumia vipimo vya kimaabara vya kansa [[Histology|histological]] kwa kuweka madoa juu ya sampuli ya [[mate]] yaliyotoka kwenye [[makohozi]], wanasayansi wanaweza kutambua MTB chini ya makroskopi (nyepesi) ya kawaida. (Phlegm pia inaitwa "kohozi.") MTB huacha madoa hata baada ya kuchanganywa na asidi, na hivyo hujulikana kama [[Acid-fast bacillus]] (AFB)<ref name= Robbins/><ref name="Madison_2001"/> acid-fast bacillus. Kuna njia mbili zinazotumia vipimo vya asidi :. Kipimo kinachojulikana kama [[Ziehl - Neelsen stain]], kinageuza rangi ya vimelea AFB na kuwa vyekundu na vinaonekana wazi wazi dhidi ya sehemu ya bluu,<ref name=Stain2000>{{cite book |author= |title=Medical Laboratory Science: Theory and Practice|publisher=Tata McGraw-Hill |location=New Delhi |year=2000 |pages=473 |isbn=0-07-463223-X|url=http://books.google.ca/books?id=lciNs3VQPLoC&pg=PA473}}</ref> na [[auramine-rhodamine stain]] ambayo hufuatiwa na makroskopi yenye kuakisi mwanga.<ref>{{cite book|last=Piot|first=editors, Richard D. Semba, Martin W. Bloem; foreword by Peter|title=Nutrition and health in developing countries|year=2008|publisher=Humana Press|location=Totowa, NJ|isbn=978-1-934115-24-4|pages=291|url=http://books.google.ca/books?id=RhH6uSQy7a4C&pg=PA291|edition=2nd ed.}}</ref>
 
Mycobacteria zingine zinazojulikana ni pamoja na " [[Mycobacterium leprae|M. leprae]], " " [[Mycobacterium avium complex|M. avium]], " na " [[Mycobacterium kansasii|M. kansasii]] ". Hizi aina mbili za mwisho zinajulikana kama " [[nontuberculous mycobacteria]] "(NTM). NTM hazisababishahazisababishi kifua kikuu au [[ukoma]], lakini husababisha magonjwa ya mapafu yanayofanana na kifua kikuu <ref name=ALA_1997>{{cite journal |title=Diagnosis and treatment of disease caused by nontuberculous mycobacteria. This official statement of the American Thoracic Society was approved by the Board of Directors, March 1997. Medical Section of the American Lung Association |journal=Am J Respir Crit Care Med |volume=156 |issue=2 Pt 2 |pages=S1–25 |year=1997 |pmid = 9279284 |author=American Thoracic Society }}</ref>
Mchangamano wa “M. tuberculosis'' (MTBC) ni pamoja na bakteria zingine nne zinazosababisha kifua kikuu {[[mycobacterium|mycobacteria]]: “[[Mycobacterium bovis|M. bovis]],” “[[Mycobacterium africanum|M. africanum]],” “[[Mycobacterium canetti|M. canetti]],” pamoja na “[[Mycobacterium microti|M. microti]].”<ref>{{cite journal|author=van Soolingen D |title=A novel pathogenic taxon of the Mycobacterium tuberculosis complex, Canetti: characterization of an exceptional isolate from Africa |journal=International Journal of Systematic Bacteriology |volume=47 |issue=4 |pages=1236–45 |year=1997 |pmid=9336935|doi=10.1099/00207713-47-4-1236 |author-separator=, |display-authors=1 |last2=Hoogenboezem |first2=T. |last3=De Haas|first3=P. E. W. |last4=Hermans |first4=P. W. M. |last5=Koedam |first5=M. A. |last6=Teppema |first6=K. S. |last7=Brennan|first7=P. J. |last8=Besra |first8=G. S. |last9=Portaels |first9=F.}}</ref> “M. africanum” haijasambaa sana, lakini ndio kisababishi kikubwa cha kifua kikuu katika maeneo ya Afrika <ref>{{cite journal |author=Niemann S |title=Mycobacterium africanum Subtype II Is Associated with Two Distinct Genotypes and Is a Major Cause of Human Tuberculosis in Kampala, Uganda|journal=J. Clin. Microbiol. |volume=40 |issue=9 |pages=3398–405 |year=2002 |pmid=12202584 |pmc=130701|doi=10.1128/JCM.40.9.3398-3405.2002 |author-separator=, |display-authors=1 |last2=Rusch-Gerdes |first2=S. |last3=Joloba|first3=M. L. |last4=Whalen |first4=C. C. |last5=Guwatudde |first5=D. |last6=Ellner |first6=J. J. |last7=Eisenach|first7=K. |last8=Fumokong |first8=N. |last9=Johnson |first9=J. L.}}</ref><ref>{{cite journal |author=Niobe-Eyangoh SN|title=Genetic Biodiversity of Mycobacterium tuberculosis Complex Strains from Patients with Pulmonary Tuberculosis in Cameroon |journal=J. Clin. Microbiol. |volume=41 |issue=6 |pages=2547–53 |year=2003 |pmid=12791879 |pmc=156567|doi=10.1128/JCM.41.6.2547-2553.2003 |author-separator=, |display-authors=1 |last2=Kuaban |first2=C. |last3=Sorlin|first3=P. |last4=Cunin |first4=P. |last5=Thonnon |first5=J. |last6=Sola |first6=C. |last7=Rastogi |first7=N.|last8=Vincent |first8=V. |last9=Gutierrez |first9=M. C.}}</ref> “M. bovis” ndio ilikuwa ni kisababishi kikubwa cha kifua kikuu, lakini baada ya kuanza kutumia [[pasteurisation|maziwa yanayopashwa moto]] vimelea vya mycobacterium vimeweza kuondolewa na kupuguza matatizo ya kiafya katika nchi zinazoendelea.<ref name=Robbins/><ref>{{cite journal |author=Thoen C, Lobue P, de Kantor I |title=The importance of''Mycobacterium bovis'' as a zoonosis |journal=Vet. Microbiol.</ref> "M. Canetti " ni adimu sana na huonekana zaidi [[Eneo la Pembezoni mwa Afrika]], ingawa kuna wagonjwa wachache kati ya wahamiaji wanaotoka Afrika. <ref>{{cite book|last=Acton|first=Q. Ashton|title=Mycobacterium Infections: New Insights for the Healthcare Professional|year=2011|publisher=ScholarlyEditions|isbn=978-1-4649-0122-5|pages=1968|url=http://books.google.ca/books?id=g2iFfV6uEuAC&pg=PA1968}}</ref><ref>{{cite journal|last=Pfyffer|first=GE|coauthors=Auckenthaler, R, van Embden, JD, van Soolingen, D|title=Mycobacterium canettii, the smooth variant of M. tuberculosis, isolated from a Swiss patient exposed in Africa.|journal=Emerging infectious diseases|date=1998 Oct-Dec|volume=4|issue=4|pages=631-4|pmid=9866740}}</ref> "M. microti" pia ni adimu na inawaathiri zaidi watu wenye upungufu wa kingamwili, ingawa ugonjwa huu unaweza kuwa umeenea zaidi kuliko inavyofikiriwa<ref>{{cite journal|last=Panteix|first=G|coauthors=Gutierrez, MC, Boschiroli, ML, Rouviere, M, Plaidy, A, Pressac, D, Porcheret, H, Chyderiotis, G, Ponsada, M, Van Oortegem, K, Salloum, S, Cabuzel, S, Bañuls, AL, Van de Perre, P, Godreuil, S|title=Pulmonary tuberculosis due to Mycobacterium microti: a study of six recent cases in France.|journal=Journal of medical microbiology|date=2010 Aug|volume=59|issue=Pt 8|pages=984-9|pmid=20488936}}</ref>
 
Mycobacteria zingine zinazojulikana ni pamoja na " [[Mycobacterium leprae|M. leprae]], " " [[Mycobacterium avium complex|M. avium]], " na " [[Mycobacterium kansasii|M. kansasii]] ". Hizi aina mbili za mwisho zinajulikana kama " [[nontuberculous mycobacteria]] "(NTM). NTM hazisababisha kifua kikuu au [[ukoma]], lakini husababisha magonjwa ya mapafu yanayofanana na kifua kikuu <ref name=ALA_1997>{{cite journal |title=Diagnosis and treatment of disease caused by nontuberculous mycobacteria. This official statement of the American Thoracic Society was approved by the Board of Directors, March 1997. Medical Section of the American Lung Association |journal=Am J Respir Crit Care Med |volume=156 |issue=2 Pt 2 |pages=S1–25 |year=1997 |pmid = 9279284 |author=American Thoracic Society }}</ref>
 
== Sababu za hatari ==
Idadi ya sababu za kufanya watu wahusike zaidi na maambukizi ya TB. Muhimu zaidi ni hatari ya kimataifa [[Virusi ya Ukimwi]] ; 13% ya kesi zote TB wameambukizwa na virusi.<ref name=WHO2011/> Hili ni tatizo hasa katika [[Afrika kusini mwa Sahara]] , ambapo viwango vya HIV ni kubwa .<ref>{{cite web author=WorldHealthOrganization|url=http://www.who.int/tb/publications/global_report/en/index.html|title=Global tuberculosis control–surveillance, planning, financing WHO Report 2006|accessdate=13 October 2006}}</ref><ref>{{cite journal|last=Chaisson|first=RE|coauthors=Martinson, NA|title=Tuberculosis in Africa--combating an HIV-driven crisis|journal=The New England Journal of Medicine|date=13 March 2008|volume=358|issue=11|pages=1089 92|pmid=18337598|doi=10.1056/NEJMp0800809}}</ref> Kifua Kikuu ni uhusiano wa karibu na wote msongamano na utapiamlo, na kuifanya moja ya magonjwa makuu ya [[makuu ya umaskini]] . This link Wale walio katika hatari ya juu hivyo ni pamoja [[ugonjwa ya umaskini]].<ref name=Lancet11/> watu ambao hujidunga dawa haramuza kulevya, wenyeji na wafanyakazi wa localesmajengo ambapo watu wanaoishi katika mazingira magumu kukusanya (kmk.m. [[gereza|magereza]] na malazi makazi), jamii wasiojiweza kimatibabu na wasio na mtaji, ya hatari kwa makabila madogo, watoto katika mawasiliano ya karibu na hatari ya hali ya juu kwa jamii ya wagonjwa na watoa huduma ya afya ya kuwahudumia wateja.<ref name=Griffith_1996>{{citejournal |author=Griffith D, Kerr C|title=Tuberculosis: disease of the past, disease of the present |journal=J Perianesth Nurs |volume=11 |issue=4|pages=240–5 |year=1996|pmid = 8964016|doi = 10.1016/S1089-9472(96)80023-2}}</ref> uvimbe sugu ni sababu nyingine hatari ya ugonjwa. Kwa [[Silicosis]] kuongeza hatari kuhusu mara 30. <ref name=table3>{{cite journal |title=Targeted tuberculin testing and treatment of latent tuberculosis infection. American Thoracic Society |journal=MMWR Recomm Rep |volume=49 |issue=RR6|pages=151|year=200|month=June|pmid=10881762|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4906a1.htm#tab3|author1=ATS/CDC Statement Committee on Latent Tuberculosis Infection}}</ref> Wale ambao moshi [[sigara]]s kuwa karibu mara mbili ya hatari ya TB ya wasiovuta sigara.<ref>{{cite journal|last=van Zyl Smit|first=RN|coauthors=Pai, M, Yew, WW, Leung, CC, Zumla, A, Bateman, ED, Dheda, K|title=Global lung health: the colliding epidemics of tuberculosis, tobacco smoking, HIV and COPD.|journal=The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology|date=2010 Jan|volume=35|issue=1|pages=27-33|pmid=20044459|quote=These analyses indicate that smokers are almost twice as likely to be infected with TB and to progress to active disease (RR of ∼1.5 for latent TB infection (LTBI) and RR of ∼2.0 for TB disease). Smokers are also twice as likely to die from TB (RR of ∼2.0 for TB mortality), but data are difficult to interpret because of heterogeneity in the results across studies.}}</ref> Baadhi ya dawa hasa yanaweza pia kuongeza hatari ya kifua kikuu katika mataifa yaliyostawi, [[ulevi]] <ref name=Lancet11/> na [[Ugonjwa wa kisukari]] (kuongezeka maratatu ).<ref>{{cite journal|last=Restrepo|first=BI|title=Convergence of the tuberculosis and diabetes epidemics: renewal of old acquaintances journal=Clinical infectious diseases : an official publication of the Infectious Diseases Society of America|date=15 August 2007|volume=45|issue=4|pages=436–8|pmid=17638190|doi=10.1086/519939|pmc=2900315}}</ref> Baadhi ya dawa, kama vile [[corticosteroids]] na [[infliximab]] (an anti-αTNF monoclonal antibody) kuwa inazidi muhimu hatari, hasa katika [[nchi zilizoendelea]].<ref name=Lancet11/> Kuna pia, [[upungufu maumbile]] <ref>{{cite journal|last=Möller|first=M|coauthors=Hoal, EG|title=Current findings, challenges and novel approaches in human genetic susceptibility to tuberculosis|journal=Tuberculosis (Edinburgh, Scotland)|date=2010 Mar|volume=90|issue=2|pages=71–83|pmid=20206579|doi=10.1016/j.tube.2010.02.002}}</ref> kwa umuhimu ambayo kwa ujumla ni bado siowekwa wazi .<ref name=Lancet11/>
 
== Mkakati ==
[[Picha:TB poster.jpg|thumb|Public health campaigns in the 1920s tried to halt the spread of TB.]]
=== UenezajiUenezi ===
Wakati watuwaliowatu walio na TB hukohoa mapafu , hupiga chafya, kuzungumza, kuimba, au kutema mate, wao hutoa viambukizi [[pekee|erosoli]] matone 0.5 na 5 [[µm]] katika [[kipenyo]]. kuchafya moja inaweza kutoa juu ya matone 40,000.<ref name=Cole_1998>{{cite journal author=Cole E, Cook C |title= Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies |journal=Am J Infect Control |volume=26 |issue=4 |pages=453–64 |year=1998|pmid=9721404|doi = 10.1016/S0196-6553(98)70046-X}}</ref> Kila moja ya matone haya wanaweza kuambukiza ugonjwa huo, tangu dozi ya kuambukiza ugonjwa wa kifua kikuu ni ya chini sana. (kuvuta pumzi ya bakteria wachache kuliko Mei 10 kusababisha maambukizi).<ref>{{cite journal |author=Nicas M, Nazaroff WW, Hubbard A |title=Toward understanding the risk of secondary airborne infection: emission of respirable pathogens |journal=J Occup Environ Hyg |volume=2 |issue=3 |pages=143–54 |year=2005|pmid=15764538|doi = 10.1080/15459620590918466}}</ref>
 
Watu wenye TB kwa muda mrefu akiwa , mara kwa mara, au karibu na watu na TB ni hatari hasa juu ya kuambukizwa, na kiwango cha wastani 22% ya kuambukiza.<ref name=Ahmed_2011>{{cite journal |author=Ahmed N, Hasnain S |title=Molecular epidemiology of tuberculosis in India: Moving forward with a systems biology approach |journal=Tuberculosis |volume=91|issue=5 |pages=407–3 |year=2011|pmid = 21514230|doi = 10.1016/j.tube.2011.03.006}}</ref> Mtu aliye na kifua kikuu hai, lakini hajatibiwa anaweza kuambukiza 10-15 (au zaidi) watu wengine kwa mwaka.<ref name="WHO2012data"/> Maambukizi lazima huwepo tu kutoka kwa watu wenye TB hai. Wale wenye maambukizi ya fiche hawadhaniwi kuambukiza. <ref name=Robbins/> uwezekano wa maambukizi kutoka kwa mtu mmoja hadi mwingine inategemea sababu kadhaa , , ikiwa ni pamoja na idadi ya matone ya kuambukiza kufukuzwa na mwenezaji , ufanisi wa uingizaji hewa, muda wa mfiduo, [[virulenceukali]] ya wa ''M. kifua kikuu'' [[strain (biolojia )|strain]], kiwango cha kinga katika mtu ambaye hajaambukizwa na wengine .<ref name=CDCcourse>{{cite web|publisher=[[Centers for Disease Control and Prevention]] (CDC), Division of Tuberculosis Elimination|url=http://www.cdc.gov/tb/education/corecurr/pdf/corecurr_all.pdf|title=Core Curriculum on Tuberculosis: What the Clinician Should Know|pg=24|edition=5th|year=2011}}</ref> ili kupunguza maenezi ya mtu-kwa-mtu tenga watu wenye TB hai (" ya wazi ") na kuweka kwenye regimenti dawa za kupambana na TB. Baada ya wiki mbili ya matibabu ya ufanisi, masomo na maambukizi [[kiuavijasumu ychacha upinzani|kutokana-upinzani]] maambukizi kwa ujumla hayazidi kuenea kwa wengine .<ref name="Ahmed_2011"/ mtu akiambukizwa yeye huchukua wiki 3 – 4 kabla ya kuanza kuambukiza wengine .<ref>{{cite web | url=http://www.mayoclinic.com/health/tuberculosis/DS00372/DSECTION=3|title=Causes of Tuberculosis|accessdate=19 October 2007|date=21 December 2006|publisher=[[Mayo Clinic]]}}</ref>
=== Uenezaji ===
Wakati watuwalio na TB hukohoa mapafu , hupiga chafya, kuzungumza, kuimba, au mate, wao hutoa viambukizi [[pekee|erosoli]] matone 0.5 na 5 [[µm]] katika kipenyo. kuchafya moja inaweza kutoa juu ya matone 40,000.<ref name=Cole_1998>{{cite journal author=Cole E, Cook C |title= Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies |journal=Am J Infect Control |volume=26 |issue=4 |pages=453–64 |year=1998|pmid=9721404|doi = 10.1016/S0196-6553(98)70046-X}}</ref> Kila moja ya matone haya wanaweza kuambukiza ugonjwa huo, tangu dozi ya kuambukiza ugonjwa wa kifua kikuu ni ya chini sana. (kuvuta pumzi ya bakteria wachache kuliko Mei 10 kusababisha maambukizi).<ref>{{cite journal |author=Nicas M, Nazaroff WW, Hubbard A |title=Toward understanding the risk of secondary airborne infection: emission of respirable pathogens |journal=J Occup Environ Hyg |volume=2 |issue=3 |pages=143–54 |year=2005|pmid=15764538|doi = 10.1080/15459620590918466}}</ref>
 
Watu wenye TB kwa muda mrefu akiwa , mara kwa mara, au karibu na watu na TB ni hatari hasa juu ya kuambukizwa, na kiwango cha wastani 22% ya kuambukiza.<ref name=Ahmed_2011>{{cite journal |author=Ahmed N, Hasnain S |title=Molecular epidemiology of tuberculosis in India: Moving forward with a systems biology approach |journal=Tuberculosis |volume=91|issue=5 |pages=407–3 |year=2011|pmid = 21514230|doi = 10.1016/j.tube.2011.03.006}}</ref> Mtu aliye na kifua kikuu hai, lakini hajatibiwa anaweza kuambukiza 10-15 (au zaidi) watu wengine kwa mwaka.<ref name="WHO2012data"/> Maambukizi lazima huwepo tu kutoka kwa watu wenye TB hai. Wale wenye maambukizi ya fiche hawadhaniwi kuambukiza. <ref name=Robbins/> uwezekano wa maambukizi kutoka kwa mtu mmoja hadi mwingine inategemea sababu kadhaa , , ikiwa ni pamoja na idadi ya matone ya kuambukiza kufukuzwa na mwenezaji , ufanisi wa uingizaji hewa, muda wa mfiduo, [[virulence]] ya ''M. kifua kikuu'' [[strain (biolojia )|strain]], kiwango cha kinga katika mtu ambaye hajaambukizwa na wengine .<ref name=CDCcourse>{{cite web|publisher=[[Centers for Disease Control and Prevention]] (CDC), Division of Tuberculosis Elimination|url=http://www.cdc.gov/tb/education/corecurr/pdf/corecurr_all.pdf|title=Core Curriculum on Tuberculosis: What the Clinician Should Know|pg=24|edition=5th|year=2011}}</ref> ili kupunguza maenezi ya mtu-kwa-mtu tenga watu wenye TB hai (" ya wazi ") na kuweka kwenye regimenti dawa za kupambana na TB. Baada ya wiki mbili ya matibabu ya ufanisi, masomo na maambukizi [[kiuavijasumu ycha upinzani|kutokana-upinzani]] maambukizi kwa ujumla hayazidi kuenea kwa wengine .<ref name="Ahmed_2011"/ mtu akiambukizwa yeye huchukua wiki 3 – 4 kabla ya kuanza kuambukiza wengine .<ref>{{cite web | url=http://www.mayoclinic.com/health/tuberculosis/DS00372/DSECTION=3|title=Causes of Tuberculosis|accessdate=19 October 2007|date=21 December 2006|publisher=[[Mayo Clinic]]}}</ref>
 
=== Pathojenesisi ===
Takribani 90% ya watu walioambukizwa ‘‘M. kifua kikuu'' na [[Dalili]], maambukizi ya TB (wakati mwingine huitwa LTBI). <ref name=Book90>{{cite book|last=Skolnik|first=Richard|title=Global health 101|year=2011|publisher=Jones & Bartlett Learning location=Burlington, MA|isbn=978-0-7637-9751-5|pages=253|url=http://books.google.ca/books?id=sBQRpj4uWmYC&pg=PA253|edition=2nd ed.}}</ref> na tu 10% maisha nafasi ya kuwa maambukizi fiche itakuwa maendeleo ya ugonjwa ya wazi, kazi ya kifua kikuu. <ref name=Arch2009> {{cite book|last=editors|first=Arch G. Mainous III, Claire Pomeroy,|title=Management of antimicrobials in infectious diseases : impact of antibiotic resistance. year=2009|publisher=Humana location=Totowa, N.J.|isbn=978-1-60327-238-4|pages=74|url=http://books.google.ca/books?id=hwVFAPLYznsC&pg=PA74|edition=2nd rev. ed.}}</ref> Katika wale wanaoishi na H.I.V, hatari ya kupatwa na TB hai inaongezeka hadi 10% karibu mwaka. <ref name=Arch2009/> Kama matibabu ya ufanisi hawakujaliwa, kiwango cha kifo kwa kesi kazi TB ni hadi 66%. <ref name=WHO2012data/>
 
TB maambukizi huanza wakati mycobacteria TB maambukizi huanza wakati [[Pulmonary alveolus pulmonary alveoli]], ambapo wao kuvamia na kuiga ndani [[endosomes]] ya alveolar [[macrophages]] tundu la mapafu.<ref name=Robbins/><ref name=Houben>{{cite journal |author=Houben E, Nguyen L, Pieters J | title=Interaction of pathogenic mycobacteria with the host immune system |journal=Curr Opin Microbiol | volume=9 | issue=1 | pages=76–85 | year=2006 | pmid=16406837 | doi=10.1016/j.mib.2005.12.014}}</ref> tovuti ya msingi ya maambukizi katika mapafu, unaojulikana kama " [[lLengoLengo Ghon focus]]", ni kwa ujumla iko katika sehemu ama juu ya tundu ya chini, au sehemu ya chini ya [[pafu|tundu juu]].<ref name=Robbins/> Kifua kikuu cha mapafu pia huweza kutokea kupitia maambukizi kutoka mkondo wa damu, Hii inajulikana kama [[lengo Simon]] . A Simon focus na ni kawaida kupatikana katika kilele cha mapafu.<ref>{{cite book|last=Khan|title=Essence Of Paediatrics|year=2011|publisher=Elsevier India|isbn=978813122803|pages=401|url=http://books.google.ca/books?id=gERCc6KTxwoC&pg=PA401}}</ref> maambukizi haya ya hematogenous yanaweza pia kusambaza maambukizi kwa maeneo ya mbali zaidi, kama vile nodiya limfu ya pembeni, mafigo, ubongo na mifupa.<ref name=Robbins/><ref name=Herrmann_2005>{{cite journal |author=Herrmann J, Lagrange P |title=Dendritic cells and ''Mycobacterium tuberculosis'': which is the Trojan horse? |journal=Pathol Biol (Paris) |volume=53 |issue=1|pages=35–40 |year=2005|pmid = 15620608 |doi=10.1016/j.patbio.2004.01.004}}</ref> Maeneo yote ya mwili yanaweza kuathirika kwa ugonjwa huo, ingawa kwa sababu isiyojulikana ni mara chache tu huathiri [[moyo]], [[skeletal misuli ]]s, [[kongosho]] , au [[tezi]].<ref>{{cite journal |author=Agarwal R, Malhotra P, Awasthi A, Kakkar N, Gupta D |pmc=1090580 |title=Tuberculous dilated cardiomyopathy: an under-recognized entity? |journal=BMCInfectDis |volume=5 |issue=1 |page=29 |year=2005|pmid=15857515 |doi=10.1186/1471-2334-5-29}}</ref>
 
Kifua Kikuu huainishwa kama moja ya magonjwa [[granuloma]] ya inflamesheni tatizi. [[Macrophage]]s, [[T cell|T lymphocytes]], [[B cell|B lymphocytes]], na [[fibroblast]]s ni miongoni mwa seli zinazoungana kuunda limfu [[granuloma]]s. [[Lymphocytes]] na lymphocytes jirani macrophages kwa walioambukizwa. Granuloma huzuia usambazaji wa mycobacteria na hutoa mazingira ya mahali hapo kwa ajili ya mwingiliano wa seli ya mfumo wa kinga. Bakteria ndani ya granuloma inawezalala, kusababisha maambukizi ya fiche. Kipengele kingine cha granulomas ni maendeleo ya kifo isiyo ya kawaida katikati ([[necrosis]]) katika kituo cha [[Tubercle (anatomia)|tubercles]]. Kwa jicho uchi, hii ina umbo la jibini laini, nyeupe na inaitwa [[caseous]] [[necrosis]]. <ref name=Grosset> {{cite journal |author=Grosset J |title=Mycobacterium tuberculosis in the Extracellular Compartment: an Underestimated Adversary |journal=Antimicrob Agents Chemother |volume=47|issue=3 |pages=833–6 |year=2003|pmid = 12604509|doi = 10.1128/AAC.47.3.833-836.2003 |pmc=149338}} </ref>
Bakteria ya TB inaweza kuingia kwenye mfumo wa damu kutokana na eneo la tishu kuharibiwa. Zinaweza kuenea kwa mwili na kuanzisha maenezi ya ukimwi, tubercles zote huonekana vidogo, nyeupe katika tishu. <ref>{{cite book|last=Crowley|first=Leonard V.|title=An introduction to human disease : pathology and pathophysiology correlations|year=2010|publisher=Jones and Bartlett|location=Sudbury, Mass.|isbn=978-0-7637-6591-0|pages=374|url=http://books.google.ca/books?id=TEiuWP4z_QIC&pg=PA374|edition=8th ed.}}</ref>Aian hii kali ya ugonjwa wa TB hupatika kawaida zaidi kwa watoto wachanga na wale wanaoishi na VVU, inaitwa [[kifua kikuu military]] .<ref>{{cite book|last=Anthony|first=Harries|title=TB/HIV a Clinical Manual.|year=2005|publisher=World Health Organization|location=Geneva|isbn=978-924154638|pages=75|url=http://books.google.ca/books?id=8dfhwKaCSxkC&pg=PA75|edition=2nd }}</ref> Watu wenye TB hii huwa na kiwango cha juu cha vifo hata kwa matibabu (takriban 30%).<ref name=Gho2008>{{cite book|last=Ghosh|first=editors-in-chief, Thomas M. Habermann, Amit K.|title=Mayo Clinic internal medicine : concise textbook|year=2008|publisher=Mayo Clinic Scientific Press|location=Rochester,MN|isbn=9781420067491|pages=789|url=http://books.google.ca/books?id=YJtodBwNxokC&pg=PA789}}</ref><ref>{{citejournal|last=Jacob|first=JT|coauthors=Mehta, AK, Leonard, MK|title=Acute forms of tuberculosis in adults.|journal=The American journal of medicine|date=2009 Jan|volume=122|issue=1|pages=12-7|pmid=19114163}}</ref>
 
Kwa watu wengi, maambukizi ya nta na hafifu. Uharibifu wa tishu na nekrisisi mara nyingi husawazishwa na [[adilifu]]. <ref name=Grosset/> Tishu zilizoathirika hubadilishwa kuwa kovu na matundu huujazwa kwa kisiesheni ya nekritiki. Wakati wwa akuuguaakuugua, baadhi ya mashimo hayo huungana na mapito ya hewa [[bronchi]] na nyenzo hii inaweza kutoka kwa kikohozi. Ni inaaina ya bakteria hai, na hivyo inaweza kueneza maambukizi. Tiba sahihi [[kiviujasumu]] inaua bakteria na inaruhusu uponyaji. Juu ya tiba, maeneo yaliyoathirika hatimaye kubadilishwa na tishu kovu. <ref name=Grosset/>
 
== Uaguzi ==
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=== Kifua Kikuu hai ===
Ni vigumu kuagua kifua kikuukwakikuu kwa misingi ya ishara na dalilitudalili tu<ref name=DiagP2011>{{cite journal|last=Bento|first=J|coauthors=Silva, AS, Rodrigues, F, Duarte, R|title=[Diagnostic tools in tuberculosis].|journal=Acta medica portuguesa|date=2011 Jan-Feb|volume=24|issue=1|pages=145–54|pmid=21672452}}</ref>Ni vigumu pai kuagua ugonjwa huo kwawatukwa watu wenye [[wanashidashida ya kinga]].<ref name=Clinic2009>{{cite journal|last=Escalante first=P|title=In the clinic. Tuberculosis. journal=Annals of internal medicine|date=2009 Jun 2|volume=150|issue=11|pages=ITC61-614; quiz ITV616|pmid=19487708}}</ref> hata hivyo watu wenye dalili za magonjwa ya mapafu [[walio na dalili]] au dalili za kudumu muda mrefu zaidi ya wiki mbili wanaweza kuwa na TB.<ref name=Clinic2009/> [[kifua X-ray]] na nyingi [[sputum utamadumi]] kwa [[bacilli asidi haraka]] ni kawaida sehemu ya tathmini ya awali.<ref name=Clinic2009/> Interferon-γ kutolewa assays na vipimo vya tuberculin ya ngozi hazisaidii katika nchi zinazoendelea.<ref>{{cite journal|last=Metcalfe first=JZ|coauthors=Everett, CK, Steinhart, KR, Cattamanchi, A, Huang, L, Hopewell, PC, Pai, M|title=Interferon-γ release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countries: systematic review and meta-analysis.|journal=The Journal of infectious diseases|date=2011 Nov 15|volume=204 Suppl4|pages=S11209|pmid=21996694}}</ref><ref>{{citejournal|last=Sester|first=M|coauthors=Sotgiu, G, Lange, C, Giehl, C, Girardi, E, Migliori, GB, Bossink, A, Dheda, K, Diel, R, Dominguez, J, Lipman, M, Nemeth, J, Ravn, P, Winkler, S, Huitric, E, Sandgren, A, Manissero, D|title=Interferon-γ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis.|journal=The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology|date=2011 Jan|volume=37|issue=1|pages=100-11|pmid=20847080}}</ref>IGRAs mapungufu sawa katika wale wanaoishi na VVU.<ref>{{cite journal|last=Chen|first=J|coauthors=Zhang, R, Wang, J, Liu, L, Zheng, Y, Shen, Y, Qi, T, Lu, H|title=Interferon-gamma release assays for the diagnosis of active tuberculosis in HIV-infected patients: a systematic review and meta-analysis.|journal=PloS one|date=2011|volume=6|issue=11|pages=e26827|pmid=22069472}}</ref><ref>{{cite journal|last=Sester|first=M|coauthors=Sotgiu, G, Lange, C, Giehl, C, Girardi, E, Migliori, GB, Bossink, A, Dheda, K, Diel, R, Dominguez, J, Lipman, M, Nemeth, J, Ravn, P, Winkler, S, Huitric, E, Sandgren, A, Manissero, D|title=Interferon-γ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis.|journal=The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology|date=2011 Jan|volume=37|issue=1|pages=100-11|pmid=20847080}}</ref>
 
Utambuzi yakinifu wa TB ni yaliyotolewa na kutambua “M. kifua KiKuu” katika sampuli ya kliniki (kwa mfano [[makohozi]], [[pus]], au [[tishu]] [[biopsy]]). Hata hivyo, ni vigumu kwa utamaduni mchakato huu viumbe polepole-kukua wanaweza kuchukua 2-6 wiki kwa ajili ya damu au utamaduni makohozi.<ref>{{cite book|last=Diseases|first=Special Programme for Research & Training in Tropical|title=Diagnostics for tuberculosis : global demand and market potential.|year=2006|publisher=World Health Organization on behalf of the Special Programme for Research and Training in Tropical Diseases|location=Geneva|isbn=978-9241563307|pages=36|url=http://books.google.ca/books?id=CFPpcCef4yQC&pg=PA36}}</ref> Hivyo, matibabu ni mara nyingi imeanza kabla ya tamaduni ni alithibitisha.<ref name=NICE2011/>
 
[[Nucleic asidi amplification mithani]] na kupita [[Triphosphate deaminase]] huweza kuruhusu uchunguzi wa haraka wa TB.<ref name=DiagP2011/> Vipimo hivi, hata hivyo, si mara kwa mara ilipendekeza, kama wao mara chache kubadilisha jinsi mtu ni kutibiwa.<ref name=NICE2011/> Vipimo vya damu ili kuchunguza kingamwili siyosi maalum au nyeti [[kingamwili siyo maalum au nyeti]] na [[unyeti na maalum au nyeti]] , hivyo si ilipendekezahaipendekezwi.<ref>{{cite journal|last=Steingart|first=KR|coauthors=Flores, LL, Dendukuri, N, Schiller, I, Laal, S, Ramsay, A, Hopewell, PC, Pai, M|title=Commercial serological tests for the diagnosis of active pulmonary and extrapulmonary tuberculosis: an updated systematic review and meta-analysis.|journal=PLoS medicine|date=2011 Aug|volume=8|issue=8|pages=e1001062|pmid=21857806|doi=10.1371/journal.pmed.1001062|pmc=3153457}}</ref>
 
== Kifua kikuu sioonekanakisichoonekana ==
[[Picha:Mantoux tuberculin skin test .jpg thumb|[[Mantoux test|Mantoux tuberculin skin test]]]]
[[Picha: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.<ref>{{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 Kikuukikuu na kudhibiti juhudi kimsingi wanategemeakunategemea 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 ==
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Matibabu ya kifua kikuu ilipendekeza mpya-mwanzo ya mapafu, kama wa 2010, ni miezi sita ya macho ya antibiotiki zenye rifampicin, isoniazidi, pyrazinamide na ethambutol kwa miezi miwili ya kwanza, na tu rifampicin na isoniazidi [[pyrazinamide]], na [[ethambutol]]. kwa miezi minne iliyopita. <ref name=Lancet11/> Ambapo upinzani isoniazidi ni ya juu, ethambutol inaweza kuongezwa kwa miezi minne iliyopita kama mbadala.<ref name=Lancet11/>
 
=== Matumizi ya Kawaidakawaida ugonjwa ===
Kama kifua kikuu kurudia, kupima na kuamua ambayo antibiotiki ni nyeti ni muhimu kabla ya kuamua matibabu. <ref name=Lancet11/> Kama [[nyingi TB sugu]] (MDR-TB) ni wanaona, matibabu na antibiotiki angalau nne madhubuti kwa ajili ya miezi 18 hadi 24 ni ilipendekeza. <ref name=Lancet11/>
 
=== Upinzani yana Dawadawa ===
Upinzani Kanuni hutokea wakati mtu huwa wameambukizwa mnachuja sugu wa TB. Mtu aliye na TB kikamilifu wanahusika inaweza kuendeleza sekondari (alipewa) upinzani wakati wa tiba kwa sababu ya tiba za kutosha, si kuchukua regimen eda ipasavyo (ukosefu wa kufuata), au kwa kutumia chini quality dawa.<ref name=OBrien>{{cite journal |author=O'Brien R |title=Drug-resistant tuberculosis: etiology, management and prevention |journal=SeminRespir Infect |volume=9 |issue=2|pages=10412 |year=1994|pmid=7973169}}</ref> Sugu TB ni mbaya ya afya ya umma suala katika nchi nyingi zinazoendelea, kama tiba yake ni tena na inahitaji dawa ghali zaidi. MDR-TB hufafanuliwa kama upinzani kwa mbili ya ufanisi zaidi madawa ya TB ya mstari wa kwanza: rifampicin na isoniazidi. . [[Extensively drug-resistant tuberculosis|Sana sugu TB]] pia ni sugu kwa tatu au zaidi ya madarasa sita ya madawa ya mstari wa pili. .<ref name="MMWR2006">{{cite journal |title=Emergence of ''Mycobacterium tuberculosis'' with extensive resistance to second-line drugs—worldwide, 2000–2004 |journal=MMWR Morb Mortal Wkly Rep |volume=55 |issue=11 |pages=301–5 |year=2006|url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5511a2.htm|pmid = 16557213 |author=Centers for Disease Control and Prevention (CDC)}}</ref> [[Totally drug-resistant tuberculosis|Kabisa sugu TB]], ambayo kwa mara ya kwanza aliona katika 2003 nchini Italia, lakini si sana taarifa mpaka 2012, ni sugu kwa madawa yote kwa sasa kutumika. <ref> {{cite web|title=Totally Resistant TB: Earliest Cases in Italy |url=http://www.wired.com/wiredscience/2012/01/tdrfirstitaly/|author=Maryn McKenna date=12 January 2012|accessdate=12 January 2012|publisher=[[Wired(magazine)|Wired]]}}</ref>
 
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== Historia ==
[[Picha:Mummy at British Museum.jpg| thumb| Egyptian [[maitiMaiti]] ya Misri katika [[Makumbusho ya Uingereza]] - kuoza lioathiriwakulikoathiriwa na kifua kikuu imekuwa kupatikanakumepatikana katika miibamifupa ya [[Egyptian]] [[mummy=maiti]]yake.]]
Kifua Kikuukikuu imekuwepokimekuwepo kwa [[binadamu]] tangu zamani saa ya karibuni [[Zamani saa ya karibuni]] sana.<ref name=Lancet11>{{cite journal|last=Lawn first=SD|coauthors=Zumla, AI|title=Tuberculosis journal=Lancet|date=2 July 2011|volume=378|issue=9785|pages=57–72|pmid=21420161|doi=10.1016/S0140-6736(10)62173-3}}</ref> Mwanzo zisizo na utata kutambua ya M. kifua kikuu inahusisha ushahidi wa ugonjwa huo katika mabaki ya bison tarehe na takriban 17,000 miaka iliyopita.<ref>{{cite journal |author=Rothschild BM |title=Mycobacterium tuberculosis complex DNA from an extinct bison dated 17,000 years before the present |journal=Clin. Infect. Dis. |volume=33 |issue=3 |pages=305–11 |year=2001|month=August |pmid=11438894 |doi=10.1086/321886 |url=http://www.journals.uchicago.edu/cgi-bin/resolve?CID001531|author-separator=, |author2=Martin LD |author3=Lev G |display-authors=3 |last4=Bercovier |first4=Helen |last5=Bar‐Gal|first5=Gila Kahila |last6=Greenblatt |first6=Charles |last7=Donoghue |first7=Helen |last8=Spigelman |first8=Mark|last9=Brittain |first9=David}}</ref> Hivyo, kama kifua kikuu asili katika mangombe, kisha kuhamishiwa kwa binadamu, au kama ni kuachana kutoka babu ya kawaida, sasa ni wazi. <ref>{{cite journal |author=Pearce-Duvet J |title=The origin of human pathogens: evaluating the role of agriculture and domestic animals in the evolution of human disease|journal=Biol Rev Camb Philos Soc |volume=81 |issue=3 |pages=369–82 |year=2006|pmid = 16672105|doi=10.1017/S1464793106007020}}</ref> kulinganisha [[gene]]s ya M. kifua kikuu tata (MTBC) kwa binadamu kwa MTBC katika wanyama unaonyesha binadamu hakuwa kupata MTBC kutoka kwa wanyama wakati wa kufuga wanyama kama ilivyoaminika hapo nyuma. Wote Matatizo ya bakteria kifua kikuu kushiriki babu ya kawaida, ambayo ingeweza kuambukizwa binadamu kama mapema kama [[Mapinduzi Neolithic]]. <ref>{{cite journal|last=Comas first=I coauthors=Gagneux, S|title=The past and future of tuberculosis research.|journal=PLoS pathogens date=2009 Oct|volume=5|issue=10|pages=e1000600|pmid=19855821}}</ref> Mabaki ya kiunzi kuonyesha prehistoric binadamu (4000 KK) [[Common Era|BC]] ) alikuwa TB. Na watafiti wamegundua kuoza enye umbo katika miiba ya [[Misri ya Egypt]] [[maiti|mummies]] kutoka BC 3000-2400.<ref>{{cite journal |author=Zink A, Sola C, Reischl U, Grabner W, Rastogi N, Wolf H, Nerlich A |title=Characterization of Mycobacterium tuberculosis Complex DNAs from Egyptian Mummies by Spoligotyping |journal=J Clin Microbiol |volume=41 |issue=1 |pages=359–67 |year=2003 |pmid=12517873|doi=10.1128/JCM.41.1.359-367.2003 |pmc=149558}}</ref> Phthisis ni neno la Kigiriki kwa ajili ya matumizi, mrefu zamani kwa ajili ya kifua kikuu cha mapafu; <ref>{{cite book|title=The Chambers Dictionary.|year=1998|publisher=Allied Chambers India Ltd.|location=New Delhi|isbn=978-81-86062-25-8|pages=352|url=http://books.google.ca/books?id=pz2ORay2HWoC&pg=RA1-PA352}}</ref> ] karibu 460 BC, [[Hippocrates]] kutambuliwa phthisis kama ugonjwa kuenea zaidi ya nyakati. Ilikuwa alisema kuhusisha homa na kukohoa ya damu, ambayo ilikuwa karibu daima mbaya. <ref>Hippocrates.[http://web.archive.org/web/20050211173218/http://classics.mit.edu/Hippocrates/aphorisms.mb.txt Aphorisms.] Accessed 7 October 2006. </ref> Masomo ya maumbile zinaonyesha TB alikuwepo katika [[Amerika]] kutoka BK mwaka 100. <ref>{{cite journal |author=Konomi N, Lebwohl E, Mowbray K, Tattersall I, Zhang D |title=Detection of Mycobacterial DNA in Andean Mummies |journal=J Clin Microbiol |volume=40 |issue=12 |pages=4738–40 |year=2002 |pmid=12454182|doi=10.1128/JCM.40.12.4738-4740.2002 |pmc=154635}}</ref>
 
Kifua Kikuu imekuwepo kwa binadamu tangu zamani saa ya karibuni [[Zamani saa ya karibuni]] .<ref name=Lancet11>{{cite journal|last=Lawn first=SD|coauthors=Zumla, AI|title=Tuberculosis journal=Lancet|date=2 July 2011|volume=378|issue=9785|pages=57–72|pmid=21420161|doi=10.1016/S0140-6736(10)62173-3}}</ref> Mwanzo zisizo na utata kutambua ya M. kifua kikuu inahusisha ushahidi wa ugonjwa huo katika mabaki ya bison tarehe na takriban 17,000 miaka iliyopita.<ref>{{cite journal |author=Rothschild BM |title=Mycobacterium tuberculosis complex DNA from an extinct bison dated 17,000 years before the present |journal=Clin. Infect. Dis. |volume=33 |issue=3 |pages=305–11 |year=2001|month=August |pmid=11438894 |doi=10.1086/321886 |url=http://www.journals.uchicago.edu/cgi-bin/resolve?CID001531|author-separator=, |author2=Martin LD |author3=Lev G |display-authors=3 |last4=Bercovier |first4=Helen |last5=Bar‐Gal|first5=Gila Kahila |last6=Greenblatt |first6=Charles |last7=Donoghue |first7=Helen |last8=Spigelman |first8=Mark|last9=Brittain |first9=David}}</ref> Hivyo, kama kifua kikuu asili katika mangombe, kisha kuhamishiwa kwa binadamu, au kama ni kuachana kutoka babu ya kawaida, sasa ni wazi. <ref>{{cite journal |author=Pearce-Duvet J |title=The origin of human pathogens: evaluating the role of agriculture and domestic animals in the evolution of human disease|journal=Biol Rev Camb Philos Soc |volume=81 |issue=3 |pages=369–82 |year=2006|pmid = 16672105|doi=10.1017/S1464793106007020}}</ref> kulinganisha [[gene]]s ya M. kifua kikuu tata (MTBC) kwa binadamu kwa MTBC katika wanyama unaonyesha binadamu hakuwa kupata MTBC kutoka kwa wanyama wakati wa kufuga wanyama kama ilivyoaminika hapo nyuma. Wote Matatizo ya bakteria kifua kikuu kushiriki babu ya kawaida, ambayo ingeweza kuambukizwa binadamu kama mapema kama [[Mapinduzi Neolithic]]. <ref>{{cite journal|last=Comas first=I coauthors=Gagneux, S|title=The past and future of tuberculosis research.|journal=PLoS pathogens date=2009 Oct|volume=5|issue=10|pages=e1000600|pmid=19855821}}</ref> Mabaki ya kiunzi kuonyesha prehistoric binadamu (4000 KK) [[Common Era|BC]] ) alikuwa TB. Na watafiti wamegundua kuoza enye umbo katika miiba ya [[Misri ya Egypt]] [[maiti|mummies]] kutoka BC 3000-2400.<ref>{{cite journal |author=Zink A, Sola C, Reischl U, Grabner W, Rastogi N, Wolf H, Nerlich A |title=Characterization of Mycobacterium tuberculosis Complex DNAs from Egyptian Mummies by Spoligotyping |journal=J Clin Microbiol |volume=41 |issue=1 |pages=359–67 |year=2003 |pmid=12517873|doi=10.1128/JCM.41.1.359-367.2003 |pmc=149558}}</ref> Phthisis ni neno la Kigiriki kwa ajili ya matumizi, mrefu zamani kwa ajili ya kifua kikuu cha mapafu; <ref>{{cite book|title=The Chambers Dictionary.|year=1998|publisher=Allied Chambers India Ltd.|location=New Delhi|isbn=978-81-86062-25-8|pages=352|url=http://books.google.ca/books?id=pz2ORay2HWoC&pg=RA1-PA352}}</ref> ] karibu 460 BC, [[Hippocrates]] kutambuliwa phthisis kama ugonjwa kuenea zaidi ya nyakati. Ilikuwa alisema kuhusisha homa na kukohoa ya damu, ambayo ilikuwa karibu daima mbaya. <ref>Hippocrates.[http://web.archive.org/web/20050211173218/http://classics.mit.edu/Hippocrates/aphorisms.mb.txt Aphorisms.] Accessed 7 October 2006. </ref> Masomo ya maumbile zinaonyesha TB alikuwepo katika [[Amerika]] kutoka BK mwaka 100. <ref>{{cite journal |author=Konomi N, Lebwohl E, Mowbray K, Tattersall I, Zhang D |title=Detection of Mycobacterial DNA in Andean Mummies |journal=J Clin Microbiol |volume=40 |issue=12 |pages=4738–40 |year=2002 |pmid=12454182|doi=10.1128/JCM.40.12.4738-4740.2002 |pmc=154635}}</ref>
 
Kabla ya [[Mapinduzi ya Viwanda]], ngano nyingi zinazohusiana na kifua kikuu [[vampire]]s. Wakati mmoja wa familia walikufa kutokana na hilo, wanachama wengine walioambukizwa bila kupoteza afya yao polepole. Watu waliamini hii kulitokana na mtu awali na TB kuondoa maji maisha kutoka kwa wanachama wengine wa familia.<ref name=sledzik>{{cite journal |last=Sledzik |first=Paul S. |coauthors=Nicholas Bellantoni |month=June |year=1994 |title=Bioarcheological and biocultural evidence for the New England vampire folk belief |journal=American Journal of Physical Anthropology |volume=94 |issue=2 |pages=269–274|doi=10.1002/ajpa.1330940210 |url=http://www.ceev.net/biocultural.pdf |format=PDF|pmid=8085617 |issn=0002-9483}}</ref>
 
Ingawa aina ya mapafu kuhusishwa na [[tubercle (anatomia )|tubercles]] ilianzishwa kama patholojia na Dr Richard Morton katika 1689.<ref name="WhoNamedIt-Calmette">{{WhoNamedIt|doctor|2413|Léon Charles Albert Calmette}}</ref><ref name="MedHist1970-Trail">{{cite journal |author=Trail RR |title=Richard Morton (1637-1698) |journal=Med Hist |volume=14|issue=2 |pages=166–74 |year=1970 |month=April |pmid=4914685 |pmc=1034037 }}</ref> kutokana na aina ya dalili yake, TB ilikuwa si kutambuliwa kama ugonjwa mmoja hadi miaka ya 1820, na haikuitwa kifua kikuu mpaka 1839 na [[Johann Lukas Schönlein|J. L. Schönlein]].<ref>Zur Pathogenie der Impetigines. Auszug aus einer brieflichen Mitteilung an den Herausgeber. [Müller’s] ''Archiv für Anatomie, Physiologie und wissenschaftliche Medicin''. 1839, page 82.</ref> Katika miaka 1838-1845, Dk John Croghan, mmiliki wa of [[Pango Mammoth]] , kuletwa idadi ya watu wenye kifua kikuu katika pango kwa matumaini ya kutibu ugonjwa na joto mara kwa mara na usafi wa hewa pango; walikufa ndani ya mwaka. <ref>[http://edition.cnn.com/2004/TRAVEL/DESTINATIONS/02/26/mammoth.cave.ap/index.html Kentucky: Mammoth Cave long on history.] ''[[CNN]]''. 27 February 2004. Accessed 8 October 2006.</ref> Hermann Brehmer kufunguliwa kwanza TB [[sanatorium]] katika 1859 katika [[Sokołowsko|Sokołowsko, Poland]].<ref name =sanatoria>{{cite journal |author=McCarthy OR |title=The key to the sanatoria |journal=J R Soc Med |volume=94 |issue=8 |pages=413–7 |year=2001 |month=August |pmid=11461990 |pmc=1281640|url=http://www.jrsm.org/cgi/pmidlookup?view=long&pmid=11461990}}</ref>
 
[[Picha: RobertKoch.jpg|upright|thumb|left|Dr. Robert Koch discovered thealigundua tuberculosis bacilli.]]
 
Kifua kikuu na kusababisha bacillus, ‘’Mycobacterium kifua kikuu ‘’, ilikuwa kutambuliwa na ilivyoelezwa kwenye Machi 24, 1882 na [[Robert Koch]]. Alipokea [[Tuzo ya Nobel katika in Fizilojia au dawa]] katika 1905 kwa ugunduzi huu. <ref>[[NobelFoundation]]. [http://nobelprize.org/nobel_prizes/medicine/laureates/1905/ The Nobel Prize in Physiology or Medicine 1905.]Accessed 7 October 2006. </ref> Koch hawakuamini bovin (ng'ombe) na kifua kikuu na magonjwa ya binadamu walikuwa sawa. Ambayo kuchelewa utambuzi wa maziwa aliyeambukizwa kama chanzo cha maambukizi. Baadaye, hatari ya maambukizi kutoka chanzo hili kasi kupunguzwa kwa uvumbuzi wa mchakato [[pasteurishaji]]. Koch alitangaza dondoo [[glycerine]] ya bacilli kinundu kama "dawa" ya kifua kikuu katika 1890, na kuiita 'tuberculin'. Wakati ilikuwa si ufanisi, baadaye mafanikio ilichukuliwa kama mtihani uchunguzi kwa ajili ya uwepo wa kifua kikuu mbele ya dalili. <ref>{{cite journal|author=Waddington K |title=To stamp out "So Terrible a Malady": bovine tuberculosis and tuberculin testing in Britain, 1890–1939 |journal=Med Hist |volume=48 |issue=1 |pages=29–48 |year=2004 |month=January |pmid=14968644 |pmc=546294 }}</ref>
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Chanjo ya BCG ina mapungufu, na utafiti wa kuendeleza chanjo ya TB mpya ni unaoendelea.<ref name=VacRes2011>{{cite journal last=Martín Montañés|first=C|coauthors=Gicquel, B|title=New tuberculosis vaccines. journal=Enfermedades infecciosas y microbiologia clinica|date=2011 Mar|volume=29 Suppl 1|pages=57–62|pmid=21420568|doi=10.1016/S0213-005X(11)70019-2}}</ref> idadi ya wagombea uwezekano ni sasa katika majaribio [[clinical trial|ya awamu ya I na II kliniki]] .<ref name=VacRes2011/> Mbili mbinu kuu ni kuwa kutumika kujaribu kuboresha ufanisi wa chanjo zinapatikana. Moja inahusisha mbinu kuongeza chanjo subunit kwa BCG, wakati mkakati mwingine ni kujaribu kujenga mpya na bora chanjo hai. <ref name=VacRes2011/> [[MVA85A]], mfano wa chanjo subunit, sasa katika majaribio nchini Afrika Kusini, ni msingi juu ya virusi vya vinasaba kufura ngozi.<ref name=Ibanga_2006>{{cite journal |author=Ibanga H, Brookes R, Hill P, Owiafe P, Fletcher H, Lienhardt C, Hill A, Adegbola R, McShane H |title=Early clinical trials with a new tuberculosis vaccine, MVA85A, in tuberculosis-endemic countries: issues in study design |journal=Lancet Infect Dis |volume=6 |issue=8|pages=522–8 |year=2006 |doi= 10.1016/S1473-3099(06)70552-7| pmid = 16870530}}</ref> Chanjo ni unaotarajiwa kuwa na jukumu muhimu katika matibabu ya wote fiche na ugonjwa hai.<ref>{{cite journal|author=Kaufmann SH|title=Future vaccination strategies against tuberculosis: Thinking outside the box|journal=Immunity|year=2010|volume=33|pages=567–77|pmid = 21029966|doi=10.1016/j.immuni.2010.09.015|issue=4}}</ref>
 
Kuhamasisha ugunduzi zaidi, watafiti na watunga sera ni kukuza mpya mifano ya kiuchumi ya maendeleo ya chanjo, ikiwa ni pamoja na zawadi, motisha ya kodi, na [[ahadi mapema Soko]] .<ref>{{cite journal|author=Webber D, Kremer M|url=http://www.who.int/bulletin/archives/79(8)735.pdf |title=Stimulating Industrial R&D for Neglected Infectious Diseases: Economic Perspectives |journal=Bulletin of the World Health Organization|volume=79|issue=8|year=2001|pages=693–801}}</ref><ref>{{cite journal|author=Barder O, Kremer M, Williams H|url=http://www.bepress.com/ev/vol3/iss3/art1 |title=Advance Market Commitments: A Policy to Stimulate Investment in Vaccines for Neglected Diseases|journal=The Economists' Voice|volume=3|year=2006|issue=3|doi=10.2202/1553-3832.1144}}</ref> Idadi ya makundi, ikiwa ni pamoja na [[Ushirikiano Stop TB]] ,<ref>{{cite book|last=Economic|first=Department of|title=Achieving the global public health agenda : dialogues at the Economic and Social Council|year=2009|publisher=United Nations|location=New York|isbn=978-92-1-104596-3|pages=103|url=http://books.google.ca/books?id=VeF9dv74C4MC&pg=PA103|coauthors=Affairs, Social}}</ref> ] Afrika Kifua Initiative Chanjo, na the [[Aeras TB Duniani Foundation Chanjo]] , wanahusika na utafiti.<ref>{{cite book|last=Jong|first=[edited by] Jane N. Zuckerman, Elaine C.|title=Travelers' vaccines|year=2010|publisher=People's Medical Pub. House|location=Shelton, CT|isbn=978-1-60795-045-5|pages=319|url=http://books.google.ca/books?id=BKRpWFEy66wC&pg=PA319|edition=2nd ed.}}</ref> Kati ya hayo, Aeras TB Duniani Chanjo Foundation alipokea zawadi ya zaidi ya $ 280,000,000 (Marekani) kutoka kwa [[Bill na Melinda Gates Foundation]] kuendeleza na leseni ya chanjo dhidi ya kifua kikuu bora kwa ajili ya matumizi katika nchi mzigo mkubwa. <ref>{{Cite web last=Bill and Melinda Gates Foundation Announcement|title=Gates Foundation Commits $82.9 Million to Develop New Tuberculosis Vaccines|date=2004-02-12| url=http://www.globalhealth.org/news/article/4134}}</ref><ref>{{Cite web last=Nightingale|first=Katherine|title=Gates foundation gives US$280 million to fight TB|date=2007-09-19|url=http://www.scidev.net/en/news/gates-foundation-gives-us280-million-to-fight-tb.html}}</ref>
 
== Katika wanyama wengine ==
Mycobacteria kuambukiza wanyama mbalimbali, ikiwa ni pamoja na ndege,<ref>{{cite journal last=Shivaprasad|first=HL|coauthors=Palmieri, C|title=Pathology of mycobacteriosis in birds.|journal=The veterinary clinics of North America. Exotic animal practice date=2012 Jan volume=15|issue=1|pages=41-55, v-vi|pmid=22244112}}</ref>panya,<ref>{{cite journal last=Reavill|first=DR|coauthors=Schmidt, RE|title=Mycobacterial lesions in fish, amphibians, reptiles, rodents, lagomorphs, and ferrets with reference to animal models.|journal=The veterinary clinics of North America. Exotic animal practice date=2012 Jan volume=15|issue=1|pages=25-40, v|pmid=22244111}} </ref> na wanyama watambaao. <ref>{{cite journal last=Mitchell|first=MA|title=Mycobacterial infections in reptiles.|journal=The veterinary clinics of North America. Exotic animal practice date=2012 Jan volume=15|issue=1|pages=101-11, vii|pmid=22244116}} </ref> subspecies Mycobacterium kifua kikuu, ingawa, ni mara chache sasa katika wanyama wa porini. <ref>{{cite book|last=Wobeser|first=Gary A.|title=Essentials of disease in wild animals|year=2006|publisher=Blackwell Publ.|location=Ames, Iowa [u.a.]|isbn=978-0-8138-0589-4|pages=170|url=http://books.google.ca/books?id=JgyS6fxVasYC&pg=PA170|edition=1st ed.}}</ref> jitihada za kutokomeza kifua kikuu ng’ombe unasababishwa na “[[Bovis Mycobacterium]] kutoka kwa ng'ombe na mifugo kulungu wa [[New Zealand]] New Zealand imekuwa na mafanikio.<ref>{{cite journal last=Ryan first=TJ|coauthors=Livingstone, PG, Ramsey, DS, de Lisle, GW, Nugent, G, Collins, DM, Buddle, BM|title=Advances in understanding disease epidemiology and implications for control and eradication of tuberculosis in livestock: the experience from New Zealand.|journal=Veterinary microbiology|date=2006 Feb 25|volume=112|issue=2-4|pages=211-9|pmid=16330161}}</ref> Jitihada katika Uingereza wamekuwa chini ya mafanikio.<ref>{{cite journal last=White|first=PC|coauthors=Böhm, M, Marion, G, Hutchings, MR|title=Control of bovine tuberculosis in British livestock: there is no 'silver bullet'.|journal=Trends in microbiology|date=2008 Sep|volume=16|issue=9|pages=420-7|pmid=18706814}}</ref><ref>{{cite journal last=Ward|first=AI|coauthors=Judge, J, Delahay, RJ|title=Farm husbandry and badger behaviour: opportunities to manage badger to cattle transmission of Mycobacterium bovis?|journal=Preventive veterinary medicine|date=2010 Jan 1|volume=93|issue=1|pages=2-10|pmid=19846226}}</ref>
 
== RejeaTanbihi ==
<references/>
 
[[Jamii:MagonjwaMaradhi ya kuambukiza]]
[[Jamii:Translators without Borders]]