Uloga PCR u javnom zdravlju
Otkrivanje bolesti koje utiču na plodnost
U Zavodu za javno zdravlje Čačak u funkciji je nova medicinska laboratorija sa najsavremenijom opremom za dijagnostiku koju su donirali Američka agencija za međunarodni razvoj (USAID) i Rotari Fondacija. Tokom pandemije koronavirusa, ova oprema je prvo korišćena za PCR dijagnostiku virusa SARS-CoV-2. Pored ostalih analiza od oktobra 2023. godine, Institut za javno zdravlje Čačak vrši testiranja primenom PCR tehnologije na prisustvo hlamidije. Implementacijom PCR testiranja na hlamidiju, Institut ne samo da doprinosi ranoj detekciji i lečenju ove infekcije, već igra i ključnu ulogu u promociji javnog zdravlja i reproduktivnog zdravlja. Ova inicijativa se uklapa u globalne napore za rešavanje neplodnosti i ističe značaj PCR tehnologije u otkrivanju bolesti koje mogu uticati na plodnost.
Neplodnost je složeno medicinsko stanje koje se karakteriše nemogućnošću začeća ili nošenja trudnoće do kraja nakon godinu dana redovnog, nezaštićenog seksualnog odnosa. Može uticati i na muškarce i na žene, a mogu je uzrokovati različiti faktori, uključujući starost, genetiku, hormonalne poremećaje, infekcije, faktore načina života i faktore okoline. Sa globalne perspektive, neplodnost je značajan javnozdravstveni problem koji pogađa milione parova širom sveta. Prema Svetskoj zdravstvenoj organizaciji (SZO), neplodnost pogađa oko 8-12% parova reproduktivne dobi širom sveta. Uticaj neplodnosti se proteže preko same nemogućnosti začeća, utičući na mentalno zdravlje pojedinaca, odnose i ukupno blagostanje. Pristup dijagnozi i lečenju neplodnosti značajno varira širom sveta, sa značajnim disparitetima između zemalja sa visokim i niskim prihodima. U mnogim zemljama sa niskim prihodima, pristup lečenju neplodnosti je ograničen zbog faktora kao što su nedostatak svesti, nedovoljna zdravstvena infrastruktura i visoki troškovi lečenja. To može rezultirati stigmom, društvenom izolacijom i smanjenim kvalitetom života za pojedince i parove koji se suočavaju sa neplodnošću. Napore za rešavanje neplodnosti na globalnom nivou čine podizanje svesti o uzrocima i posledicama neplodnosti, poboljšanje pristupa pristupačnim i efikasnim tretmanima neplodnosti i pružanje podrške i savetovanja pojedincima i parovima koji se suočavaju sa neplodnošću. Rešavanje neplodnosti zahteva višefaktorski pristup uključujući zdravstvene radnike, donosioce odluka i zajednicu kako bi se osiguralo da pojedinci i parovi koji se suočavaju sa neplodnošću dobiju negu i podršku koja im je potrebna. Hlamidija trahomatis je bakterija koja može izazvati seksualno prenosivu infekciju (STI). To je jedna od najčešćih STI-ova globalno, posebno pogađajući mlade ljude. Hlamidija često ne pokazuje simptome, što znači da zaraženi pojedinci mogu biti bez simptoma, što može dovesti do nelečenih infekcija i potencijalnih komplikacija poput neplodnosti.
U kontekstu neplodnosti, hlamidija trahomatis je značajna jer može uzrokovati upalu karlice (PID) kod žena, što može dovesti do ožiljaka i oštećenja jajovoda. Ovi ožiljci mogu rezultirati začepljenjem jajovoda, što može sprečiti jajnu ćeliju da bude oplođena ili da stigne do materice, što dovodi do neplodnosti. PCR (polimerazna lančana reakcija) tehnologija je izuzetno važna u dijagnozi infekcije hlamidijom trahomatis. PCR omogućava otkrivanje DNK bakterije u uzorcima kao što su urin, vaginalni brisevi ili cervikalni brisevi sa visokom osetljivošću i specifičnošću. To znači da PCR može tačno identifikovati prisustvo hlamidije trahomatis čak i u slučajevima kada infekcija nema simptome.
Rana i tačna dijagnoza hlamidije je ključna za pravovremeno lečenje kako bi se sprečile komplikacije poput neplodnosti. Pored toga, brza i pouzdana dijagnoza seksualno prenosivih bolesti izuzetno je važna za lečenje infertilnih parova i parova koji se odluče za vantelesnu oplodnju. Ukratko, hlamidija trahomatis je uobičajena STI koja može dovesti do neplodnosti ako se ne leči, posebno kod žena. PCR tehnologija igra ključnu ulogu u dijagnozi hlamidije, omogućavajući rano otkrivanje i lečenje kako bi se sprečile dugoročne komplikacije.
Podsećamo da je inicijativa za otvaranje nove PCR laboratorije sa najsavremenijom molekularnom dijagnostičkom opremom došla radi prevencije i borbe protiv infektivnih bolesti. Projekat je finansiran kroz jedinstveno i vidljivo partnerstvo između Rotary International i USAID-a i pravi je primer izuzetne sinergije između lokalne samouprave, zdravstvene zajednice, stanovništva, Rotary organizacije i USAID-a.
„Ovaj članak je omogućen velikodušnom podrškom američkog naroda preko Agencije za međunarodni razvoj Sjedinjenih Američkih Država (USAID). Sadržaj je odgovornost Rotari kluba Čačak, Srbija i ne mora nužno odražavati stavove USAID-a ili Vlade Sjedinjenih Američkih Država.“
Rotari klub Čačak
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The Role of PCR in Public Health
Detecting Diseases Affecting Fertility
Infertility is a complex medical condition characterized by the inability to conceive or carry a pregnancy to term after one year of regular, unprotected sexual intercourse. It can affect both men and women and can be caused by various factors, including age, genetics, hormonal disorders, infections, lifestyle factors, and environmental factors. From a global perspective, infertility is a significant public health problem affecting millions of couples worldwide. According to the World Health Organization (WHO), infertility affects about 8-12% of reproductive-aged couples worldwide. The impact of infertility extends beyond the inability to conceive, affecting the mental health of individuals, relationships, and overall well-being. The approach to the diagnosis and treatment of infertility varies significantly worldwide, with significant disparities between high- and low-income countries. In many low-income countries, access to infertility treatment is limited due to factors such as lack of awareness, inadequate health infrastructure, and high treatment costs. This can result in stigma, social isolation, and reduced quality of life for individuals and couples facing infertility. Global efforts to address infertility include raising awareness about the causes and consequences of infertility, improving access to affordable and effective infertility treatments, and providing support and counseling to individuals and couples facing infertility. Addressing infertility requires a multifaceted approach involving healthcare workers, decision-makers, and the community to ensure that individuals and couples facing infertility receive the care and support they need.
Chlamydia trachomatis is a bacterium that can cause a sexually transmitted infection (STI). It is one of the most common STIs globally, particularly affecting young people. Chlamydia often does not show symptoms, meaning infected individuals can be asymptomatic, leading to untreated infections and potential complications such as infertility. In the context of infertility, Chlamydia trachomatis is significant because it can cause pelvic inflammatory disease (PID) in women, which can lead to scarring and damage to the fallopian tubes. These scars can result in blockages of the fallopian tubes, preventing the egg from being fertilized or reaching the uterus, leading to infertility.
PCR (polymerase chain reaction) technology is extremely important in the diagnosis of Chlamydia trachomatis infection. PCR enables the detection of the bacterium’s DNA in samples such as urine, vaginal swabs, or cervical swabs with high sensitivity and specificity. This means that PCR can accurately identify the presence of Chlamydia trachomatis even in cases where the infection is asymptomatic. Early and accurate diagnosis of chlamydia is crucial for timely treatment to prevent complications such as infertility.
Furthermore, rapid and reliable diagnosis of sexually transmitted infections is extremely important for the treatment of infertile couples and couples opting for in vitro fertilization. In summary, Chlamydia trachomatis is a common STI that can lead to infertility if left untreated, especially in women. PCR technology plays a key role in the diagnosis of chlamydia, enabling early detection and treatment to prevent long-term complications.
Since October 2023, the Public Health Institute Čačak has been conducting testing for the presence of chlamydia using PCR technology. By implementing PCR testing for chlamydia, the Institute not only contributes to the early detection and treatment of this infection but also plays a crucial role in promoting public health and reproductive health. This initiative is in line with global efforts to address infertility and highlights the importance of PCR technology in detecting diseases that can affect fertility.
It is worth noting that the initiative to open a new PCR laboratory with state-of-the-art molecular diagnostic equipment came as a result of collaboration between the broader community, healthcare workers, the city hospital, the Public Health Institute, and the City of Čačak. The local government, to protect the health of its citizens, provided funds for the construction of a new and modern building where the PCR laboratory was established. At the same time, service organizations, such as Rotary Club Čačak, as a local partner, and Rotary Club Austin, USA, as an international partner, recognized the needs of the citizens and proposed the „Stop Covid-19“ project. The project aims to procure equipment for the PCR laboratory while simultaneously educating the population to prevent and combat infectious diseases. The name of the project was conceived at a time when the crisis caused by Covid-19 was at its peak, both in our country and globally. PCR (or polymerase chain reaction) is a necessary and cutting-edge method in today’s molecular research. The project is funded through a unique and visible partnership between Rotary International and USAID and is a prime example of exceptional synergy between local government, the healthcare community, the population, Rotary organizations, and USAID.
“This article is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Rotary Club Cacak, Serbia and do not necessarily reflect the views of USAID or the United States Government.”
