Bwetuwulira ekigambo PCR, tulowooza ku kirwadde kya Covid, nedda? Ekiseera we twalina okusiba ekiso mu nnyindo ne tulinda lipoota okujja... ekyo tekijja kwerabirwa. Naye okimanyi nti PCR tekozesebwa kuzuula Covid yokka? Mu butuufu kino kigezo kikulu nnyo ekikoze enkulaakulana ey’amaanyi mu sayansi w’obusawo. Kale leero, ka twogere ku kigezo kino ekya PCR kye ki, ebintu ebirala bye kiyinza okuzuula, n’engeri gye kikola mu ngeri ennyangu gy’osobola okutegeera.
PCR kye ki mu ngeri ennyangu?
Okay, ka tukiteeke bwe tuti. Teebereza nti walina okusanga ekigambo kimu ku lupapula lumu olw’ekitabo kimu, ku nkumi n’enkumi z’ebitabo ebiri mu tterekero eddene. Ekyo kyandibadde kizibu kitya? Kiringa okuzuula akatundu akatono aka DNA oba RNA , ekintu eky’obuzaale ekiri munda mu butoffaali mu mibiri gyaffe.
Tekinologiya wa PCR (Polymerase Chain Reaction) ayamba omulimu ogwo omuzibu. Kino kye kikola kwe kukoppa ekitundu kya DNA oba RNA ekisinga obutono kye tunoonya emirundi n’obukadde, wadde obukadde n’obukadde (amplification). Kiba ng’okuzuula olupapula oluliko ekigambo mu kitabo ky’etterekero, n’okiteeka mu kyuma ekikuba ebifaananyi, n’okola kkopi nga obukadde. Olwo, olw’okuba ekigambo ekyo ekizibu okusanga kati kiri buli wamu, kyangu okukitegeera.
Mu ngeri ennyangu, PCR kwe kukebera okuggya akatoffaali akatono ennyo mu mubiri gwaffe, ettondo ly’omusaayi, oba ekyuma ekikuba ennyindo, ne kikula mu ngeri ey’ekikugu ekitundu kya DNA oba RNA ekigere mu kyo mu laboratory okukakasa oba kiri mu sampuli yaffe oba nedda. Kino kigezo kizibu nnyo. Kino kitegeeza nti esobola okuzuula akawuka kano ne katono ennyo. Enkola eno eri mu kibinja ky’ebigezo ebiyitibwa Nucleic Acid Amplification Test (NAAT).
Endwadde ki eziyinza okuzuulibwa nga zikeberebwa mu ngeri ya PCR?
Wadde nga PCR efuuse ettutumu olw’ekirwadde kya COVID, ebadde ekozesebwa mu nsi y’obusawo okumala emyaka mingi. Waliwo ebintu bingi ebiyinza okuzuulibwa n’okukebera kuno. Ka tulabe ebimu ku bikulu.
| Ebiyinza okuzuulibwa | Ebyokulabirako n’okunnyonnyola |
|---|---|
| Endwadde ezisiigibwa | Kisobola okuzuula endwadde ezireetebwa obuwuka obutonotono nga akawuka, obuwuka, ffene, n’obuwuka obusirikitu. Okugeza PCR ekozesebwa okuzuula obulungi endwadde nga COVID-19, dengue, influenza (flu), akafuba, siriimu, ne hepatitis B ne C. |
| Endwadde z’obuzaale | Endwadde ezimu zisikira okuyita mu buzaale. PCR eyamba okuzuula enkyukakyuka ezimu (mutations) mu buzaale buno. Eby’okulabirako: Obulwadde bwa Cystic Fibrosis, obulwadde bwa Huntington. |
| Kookolo | Okukebera kuno kusobola okuzuula enkyukakyuka ezenjawulo mu buzaale mu butoffaali bwa kookolo. Kino kiyinza okuyamba abasawo okulonda eddagala eriyinza okutunuulira kookolo oyo (targeted therapy). |
| Okukebera nga tonnazaala | Tekinologiya wa PCR akozesebwa mu kukebera okuzuula nga bukyali oba omwana ali mu lubuto lwa maama alina endwadde zonna ez’obuzaale. |
| Sayansi w’okunoonyereza ku misango | DNA eggyibwa mu musaayi oba enviiri entono ennyo ezisangibwa mu kifo awaali omusango, n’egaziwa nga bakozesa tekinologiya wa PCR, n’ekozesebwa okuzuula abateeberezebwa. |
Okwata otya sampuli okukeberebwa PCR?
Engeri gy’okwatamu sampuli okukeberebwa PCR esinziira ku kika ky’obulwadde bw’onoonya. Enkola y’okutwala sampuli ya njawulo ku buli mbeera.
| Enkola y’okutwala sampuli | Kino kikolebwa mu mbeera ya ngeri ki? |
|---|---|
| Okukebera omusaayi (Okukebera omusaayi) . | Omusaayi gutwalibwa okuzuula endwadde z’obuzaale, wamu n’okuzuula akawuka akamu (e.g. HIV, Hepatitis B/C) akayingidde mu musaayi. |
| Okusiiga ennyindo mu nnyindo | Eno y’enkola ffenna gye tumanyi. Jjukira bwewasiba omuggo waggulu mu nnyindo mu kiseera kya Covid? Enkola eno ekozesebwa okuzuula akawuka akakosa enkola y’okussa (COVID, Influenza, RSV). |
| Okukebera ebitundu by’omubiri (biopsy). | Sampuli eno eggyibwa mu kitundu ekitono eky’omubiri okuva mu kizimba kya kookolo oba obusigo bw’amagumba n’ekozesebwa okunoonya enkyukakyuka mu buzaale mu butoffaali. |
| Obulwadde bwa Amniocentesis | Kino kikolebwa okugezesa embeera y’obuzaale bw’omwana nga baggya akatono ku mazzi g’omu lubuto ageetoolodde omwana okuva ku maama ali olubuto. |
| Okuzuula obuzaale nga tebannaba kusimba | In vitro fertilization (IVF), enkola eno ekozesebwa okugezesa obutoffaali obutonotono okuva mu nkwaso okulaba oba erina endwadde z’obuzaale nga tennasimbibwa mu nnabaana wa maama. |
Ebiseera ebisinga, teweetaaga kukola kintu kya njawulo okwetegekera okukeberebwa PCR. Wabula mu mbeera ezimu, gamba ng’okola ekintu ng’okukebera omubiri, omusawo ajja kukuwa ebiragiro ebyetaagisa nga bukyali.
Tekinologiya wa PCR akola atya?
Okay, kati ka tulabe engeri tekinologiya ono eyeewuunyisa gy’akola mu butuufu. Kino kya ssaayansi katono, naye nja kukinnyonnyola mu ngeri ennyangu.
1. Okuteekateeka sampuli: Okusooka, DNA oba RNA eyawulwa okuva mu sampuli (omusaayi, ebifulumizibwa n’ebirala) ekuggyiddwako.
2. Okukola omutabula: Ekiddako, DNA/RNA eno eyawuddwamu etabulwamu eddagala erimu ery’enjawulo. Ekikulu mu nsengekera eno ye enzyme eyitibwa DNA Polymerase . Eno y’esinga okukola omulimu gw’okukoppa.
3. Enzirukanya y’okubugumya n’okunyogoza: Kati akayumba akatono akalimu omutabula guno kateekebwa mu kyuma eky’enjawulo. Ekyuma kino kisitula n’okukka ebbugumu mu bwangu ddala.
- Okukyusa obutonde: Okusooka, ebbugumu lyongezebwa okutuuka ku diguli nga 95. Kino kireetera emiguwa gya DNA ebbiri okwawukana.
- Annealing: Ekiddako, ebbugumu likendeezebwa okutuuka ku diguli nga 55. Olwo, obutundutundu obutono obwa DNA (primers) obukwatagana n’ekitundu kya DNA kye tunoonya buyungibwa ku miguwa gya DNA egyawuddwamu.
- Okuddamu okubugumya (Extension): Olwo ebbugumu ne lirinnyisibwa okutuuka ku diguli nga 72. Olwo enziyiza ya DNA polymerase n’eyingira n’ekola oluwuzi lwa DNA olupya okuva mu primer eyo olukwatagana n’oluwuzi lwa DNA olwasooka.
4. Okukoppa: Kati kkopi bbiri ez’omuguwa gumu ogwa DNA zikoleddwa. Enzirukanya eno ey’ebbugumu eddiŋŋana emirundi nga 30-40. Mu nsengekera emu, obungi bwa DNA bweyongera emirundi ebiri. Ebibiri bifuuka bina, bina bifuuka munaana, munaana bifuuka kkumi na mukaaga... Oluvannyuma lw’enzirukanya nga 30, kkopi ezisoba mu kawumbi zikoleddwa okuva mu kitundu kya DNA ekimu ekyasooka.
Kati, akatundu ako aka DNA/RNA, edda akaali katono nnyo okusobola okuzuulibwa, kafuuse kanene ekimala okusobola okwanguyirwa okuzuulibwa.
Waliwo ebika by’okukebera PCR?
Yee, okusinga waliwo ebika bibiri bye twetaaga okumanya.
- Reverse-transcriptase PCR (RT-PCR): Akawuka akamu, nga Covid, ssennyiga, ne siriimu, amawulire gaabwe ag’obuzaale mu RNA okusinga DNA. PCR eya bulijjo esobola okukoppa DNA yokka. Kale, ky’okola mu RT-PCR kwe kusooka okukozesa enziyiza ey’enjawulo (`Reverse Transcriptase`) ‘okukyusa’ RNA eyo mu DNA. DNA evuddemu eyitibwa DNA ejjuliza (cDNA). Olwo enkola ya PCR eya bulijjo n’ebaawo.
- Real-time PCR / Quantitative PCR (Q-PCR): Eno nkola ya mulembe katono. Ekibaawo mu kino kiri nti DNA bw’ekoppololwa, akabonero akalaga ekitangaala (fluorescent label) kagiteekako. Omuwendo gwa DNA ogukoppololwa bwe gweyongera, ekitangaala kino nakyo kyeyongera. Ekyuma kino kisobola okupima ekitangaala kino. So, while we are waiting, that is, in real-time , tusobola okulaba oba DNA ekwatagana eriwo mu sampuli oba nedda. Tekikoma awo, era kiyinza okuwa endowooza enkakali ku bungi bwa akawuka kaali mu sampuli eyasooka (viral load). Ekigezo kya Real-time RT-PCR ekigatta enkola zino zombi kitera okukozesebwa okuzuula Covid.
Lipoota ya PCR etegeeza ki?
Kikulu nnyo okutegeera lipoota ya PCR ng’ogifunye.
- Detected / Positive: Singa lipoota yo egamba nti "Detected" oba "Positive," kitegeeza nti sampuli yo yalimu ebitundu by'akawuka oba obuzaale bwe baali banoonya. Mu ngeri ennyangu, osanga olina obulwadde buno.
- Not Detected / Negative: Kino kitegeeza nti ebitundu bya DNA/RNA ebikwatagana tebyasobodde kusangibwa mu sampuli eyakeberebwa. Kino kitegeeza nti osanga tolina bulwadde obwo.
Naye wuuno ekintu ekikulu ennyo. Oluusi, singa okebera mu nnaku ezisooka ng’ofunye obulwadde (naddala ng’obubonero tebunnatandika), obungi bw’akawuka mu mubiri gwo buyinza okuba obutono era PCR eyinza obutakazuula. Kale, ne bw’ofuna ‘Not Detected’ result, bw’oba okyalina obubonero, kirungi okwogera n’omusawo wo n’ogoberera amagezi ge. Oyinza okusabibwa okuddamu okugezesa mu nnaku ntono.
Ebbanga lye kitwala okufuna ebyavaamu lyawukana okusinziira ku kukebera okukolebwa. Ennyindo (nga COVID, influenza) zitera okufuna ebivaamu mu ssaawa 24 zokka. Kyokka okukebera omusaayi n’okukebera omusaayi okunoonya endwadde z’obuzaale kiyinza okutwala wiiki emu oba okusingawo.
Bw’oba olina ekibuuzo kyonna oba ekikweraliikiriza ku kukebera kwa PCR oba ebyavaamu, kakasa nti oyogera n’omusawo wo ku nsonga eno.
Obubaka Obutwala Awaka
- PCR si kwekebeza COVID yokka. Kye kigezo ky’abasawo eky’amaanyi ennyo era ekituufu ekikozesebwa okuzuula yinfekisoni ez’enjawulo, endwadde z’obuzaale, n’embeera nga kookolo.
- Tekinologiya ono akoppa DNA oba RNA entono ennyo mu sampuli n’agifuula obukadde n’obukadde bwa kkopi, n’agituusa ku ddaala eryangu okuzuulibwa.
- Ne bwe kiba nti ebyava mu PCR biba "Not Detected" (Negative), bw'oba olina obubonero, tekitegeeza 100% nti tolina bulwadde buno. Kino kiyinza okubaawo naddala mu mitendera egy’okusooka egy’okukwatibwa yinfekisoni.
- Omusawo wo y’asinga okuddamu ebibuuzo byonna oba ebikweraliikiriza by’oyinza okuba nabyo ku bivudde mu kukeberebwa kwo n’embeera y’obulamu bwo, n’olwekyo tolwawo kwogera naye.
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