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Sensitivity vs Specificity: Vipimo vya maabara huwa sahihi kama ukipima kile kinachotakiwa kupimwa. Njia ya upimaji tutasema ni bora pale ambapo kipimo kimoja kitapimwa zaidi ya mara moja na kutupa majibu yanayofanana. Kwa kifupi hapa tunamaanisha usahihi wa kipimo.
Sensitivity: Ni ule uwezo wa kipimo kugundua watu walio na ugonjwa. Mfano: Kipimo kimehakikiwa kuwa 90% sensitive. Hii inamaanisha, Kama watu 100 wanaojulikana kuwa na ugonjwa wakipimwa, watu 90 kati ya 100 watakutwa na ugonjwa.
Unapoongelea sensitivity ya kipimo unaongelea ule uwezo wake wa kusema huyu mtu ana ugonjwa ikiwa kweli anao (test positive when disease present). Kipimo chenye uwezo huu kikikupa majibu negative basi ni hakika hamna ugonjwa kwa mtu husika.
Kwa lugha nyingine naweza sema vipimo vilivyotengenezwa kwa uwezo mkubwa wa sensitivity haviwezi kukosea iwapo kuna ugonjwa kwa mtu husika hivyo kuwa na uhakika kama majibu yakiwa negative. Majibu ya kipimo kilicho na uwezo mkubwa wa sensitivity huwa ya kuaminika yakiwa negative.
Kwanini nasema majibu negative huaminika? Kipimo hiki hakiwezi kukosa ugonjwa kama ugonjwa huo upo, ubaya wa kipimo hiki ni kuwa hata ikitokea kuna ugonjwa mwingine unaoendana na ugonjwa unaopimwa bado itasema positive ndio maana kikisema mtu hana ugonjwa ni kweli hana.
Najua nimekuacha kidogo, Upande wa wadudu waambukizao magonjwa kila mdudu ana familia yake. mfano huyu coronavirus ana familia kama MERS na SARS, sasa kipimo cha sensitivity kubwa kitapima uwepo wa kirusi cha corona bila kujali ni SARS au MERS maana ni sensitive kwa coronavirus.
Sasa ukitaka kutafuta wagonjwa wa MERS-Cov huwezi kutumia kipimo cha sensitivity maana kitakupa majibu hata ya SARS-Cov. Ndio maana nimesema majibu ya negative kwa kipimo cha sensitivity kubwa huwa yenye uhakika na ni kweli mtu huyo hana ugonjwa. Natumai umeelewa mpaka hapo.
Mpaka hapa tukiongelea specificity ushapata picha sio? Specificity ni ule uwezo wa kipimo kugundua watu wasio na ugonjwa. Mfano: Kipimo kimehakikiwa kuwa 90% specificity. Hii inamaanisha, Kama watu 100 wasio na ugonjwa wakipimwa, watu 90 kati ya 100 watakutwa hawana ugonjwa.
Specificity ya kipimo ni ule uwezo wa kusema huyu mtu hana ugonjwa ikiwa kweli mtu huyo hana ugonjwa. sasa tukirudi kwenye mfano wangu hapo nyuma wa SARS na MERS. Kipimo kilichotengenezwa kuwa na uwezo mkubwa wa specificity huwa maalumu zaidi kwa kile unachopima.
Mara nyingi vipimo hivi hutengenezwa maalumu kwa ajili ya mdudu fulani maabara huwa tunaita ni confirmatory test. Mgonjwa atafika utampima na kipimo cha sensitivity ikiwa negative utaishia hapo na kutoa majibu, ikiwa positive utaendelea mbele na specificity kujua ni mdudu gani.
Vipimo (sensitive na specific) huwa tofauti hata kwa gharama na upatikanaji wake. Kilicho na uwezo mkubwa wa specificity huwa ngumu kupatikana na gharama yake huwa juu maana huwa maalumu zaidi kwa ugonjwa/mdudu. Ni muhimu kutumia vipimo vyote kabla ya kutoa majibu ya positive.
Niwape stori kidogo, Wakati nipo chuo iliwahi kutokea kesi moja. Mdada mmoja alitaka kwenda kupima ukimwi lakini kutokana na aibu ilibidi aongee na jamaa yake ambae ni nesi pale hospitali amchukulie kipimo cha ukimwi (bioline) ili apime akiwa nyumbani na jamaa alifanya hivyo.
Sasa kama nilivyosema kuna vipimo vyenye uwezo mkubwa wa sensitivity ambavyo ndio hivi tunavyo mitaani ambavyo kwa maabara huwa ni determining test tu. tunatolea majibu kama majibu yakiwa negative tu lakini yakiwa positive tunatumia kipimo kingine chenye specificity kuhakiki.
Kipimo hiki cha kuhakiki (uni-gold) huwa hakitolewi kirahisi na hata ukitumia casset moja lazima uitolee maelezo umeitumia kwa nani? na huyu mgonjwa lazima umpe refferal aende CTC kupata ushauri nasaha na hata kuanza dawa. Sasa unaona ilivyo ngumu kukipata sio.
Sasa yule dada akaenda kujipima huko kwake kama kawaida mnaojipima mnaelewa mnafanya nini, wengine wanaweka maji kwa kukosa maji maalumu ya kipimo (buffer) yule dada kupima ikatokea mistari miwili, Acha yule dada achanganyikiwa hadi kuzimia.
Baada ya kuletwa hospitali na kupatiwa huduma ya kwanza akazinduka ndipo akaeleza nini kimemkuta ikabidi turudie kupima tena majibu yakaja negative. Kumbe huyu dada alikua na maambukizi mengine ya kirusi lakini sio VVU.
Kwaiyo basi. Mashine za maabara hutumiwa kwa kuzingatia asilimia za sensitivity na specificity
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