Abstract

Menurut World Health Organization sekitar sepertiga penduduk dunia telah terinfeksi kuman tuberkulosis dan deteksi dini pada kontak serumah dengan penderita memungkinkan upaya pengobatan dan pencegahan dilakukan dengan efektif. Penelitian ini bertujuan untuk membandingkan hasil pemeriksaan tes Mantoux dengan pemeriksaan serologis kadar interferon gamma (IFN - γ) pada kelompok kontak serumah dengan penderita tuberkulosis yang mempunyai hasil pemeriksaan basil tahan asam (BTA) positif. Penelitian ini menggunakan desain kohort pada kelompok terpajan dan tidak terpajan pada penderita tuberkulosis (umur > 15 tahun). Pemilihan subjek dilakukan secara acak sederhana dan jumlah yang digunakan adalah 34 orang pada masing-masing kelompok. Penelitian ini menggunakan tes Mantoux selain observasi kadar IFN-γ. Analisis data menggunakan chi square dan tes Man Whitney. Penelitian tahun pertama menunjukkan hasil tes Mantoux positif pada kelompok terpajan sebesar 79,4% dan 5,9% pada kelompok tidak terpajan. Rata-rata kadar IFN - γ pada kelompok yang terpajan penderita tuberkulosis adalah 5,32 pg/ml sedangkan pada kelompok yang tidak terpajan sebesar 1,1 pg/ml. Ada hubungan yang bermakna antara status paparan dengan hasil tes Mantoux (nilai p = 0,0001 dan x2= 34,631). Ada perbedaan rata-rata kadar IFNγ secara bermakna antara kelompok terpajan dengan kelompok yang tidak terpajan (nilai p = 0,0001). Masih diperlukan penelitian lebih lanjut untuk mengikuti perkembangan IFN-γ berdasarkan status paparan untuk mengetahui pola dan cut off point pada kontak serumah dengan penderita tuberkulosis.

World Health Organization estimated that one third people worldwide were infected with mycobacterium tuberculosis. An early diagnosis and prompt treatment of possible pulmonary tuberculosis infection should be made for close contacts (housemate contacts) of patient with tuberculosis. The purpose of this research is to analyze the differences levels of IFN-γ and Tuberculine Skin Test (TST) on the housemate contacts and non-house- mate contacts with patients of tuberculosis. Cohort study performed on the housemate contacts and non-housemate contacts with patients of tuberculosis (age > 15 years old). We collected data with simple random sampling on 68 persons (34 exposed and 34 unexposed). Bivariate associations were described using chi square and Man Whitney test. During the first year of study, 76,4% of exposed persons with TST positive and 5,9% of unexposed persons. Average levels of IFN - γ in exposed persons 5,32 pg/ml, whereas in other groups 1,1 pg/ml. There is relationship between exposure sta- tus and unexposed status of TST (p value = 0,0001 and x2 = 34,631). There are differences in mean levels of IFN - γ between group exposed and unexposed (p value = 0,0001). Further research will be needed to keep abreast of IFN - γ level on the basis of exposure status to know the cut off point on the housemate contacts with patients of tuberculosis.

References

  1. World Health Organization. WHO report 2011-global tuberculosis control. Geneva: World Health Organization; 2011 [cited 2012 Jan 12]. Available from: http://www.who.int/TB/data.
  2. Sub Direktorat Tuberkulosis Kementerian Kesehatan Republik Indonesia, World Health Organization. Lembar fakta tuberkulosis. Hari TB Indonesia. Jakarta: Sub Direktorat Tuberkulosis Kementerian Kesehatan Republik Indonesia, World Health Organization; 2008.
  3. Kementerian Kesehatan Republik Indonesia. Situasi epidemiologi tuberkulosis Indonesia. Jakarta: Kementerian Kesehatan Republik Indonesia; 2010 [diakses tanggal 12 Januari 2012]. Available from: http://www. TBindonesia.or.id.
  4. Dinas Kesehatan Kota Semarang. Profil kesehatan Kota Semarang 2009. Semarang: Dinas Kesehatan Kota Semarang; 2010.
  5. Direktorat Jenderal Pemberantasan Penyakit Menular Kementerian Kesehatan Republik Indonesia. Modul pelatihan program pemberantasan penyakit tuberkulosis tingkat puskesmas. Jakarta: Kementerian Kesehatan Republik Indonesia; 1997.
  6. M Garbati H, Yusuph, M Kagu, A Moses. Diagnosis of pulmonar tuberculosis: utility serolog an mantoux reaction in a source-limited setting. The Internet Journal of Infectious Disease. 2010.
  7. Hussain S, Afsal N, Javaid K, Ullah M, Ahmad T, Saleem UZ. Level of interferon gamma in the blood of tuberculosis patients. Iranian Journal Immunology. 2010; 4: 240-6.
  8. Carandang EH. Re-evaluation of test mantoux in Filipino adults: a preliminary study. Philippine Journal of Microbiology Infectious Disease. 1998; 17(1): 29-33.
  9. Lee JY, Choi HJ, Park IN, Hong SB, Obr Mh, YM, Lim, et al. Comparson of two commercial interferon gamma assay for diagnosis mycobacterium tuberculosis infection. Eur Re. 2006; 28 (1): 24-30.
  10. Sakti H. Kadar interferon gamma penyandang tuberkulosis [disertasi]. Yogyakarta: Fakultas Psikologi Universitas Gadjah Mada; 2010.
  11. Koksal D, Unsal E, Poyraraz B, Kaya A, Savas H, Sipit T, et al. The value of serum interferon gamma level in the differensial diagnosis of active and inactive pulmonary tuberculosis. Tuberk Toraks. 2006; 54 (1): 17-21.
  12. Arend SM, Thijsen SFT, Leyten EMS, Bouwman JJM, Franken WPJ, Koster BFPJ, et al. Comparison of two interferon assays and tuberculin skin test for tracing tuberculosis contacts. American Journal of Respiratory and Critical Medicine. 2007; 175: 618-27.
  13. Adetifa IMO, Lugos MD, Hammond A, Jeffries D, Donkor S, Adegloba RA, Hill PC. Comparison of two interferon gamma release assay in the diagnosis of mycobacterium tuberculosis infection and disease in The Gambia. BMC Infectious Disease. 200; 7: 122.
  14. Ahmad S. New approaches in the diagnosis and treatment of latent tuberculosis infection. Respiratory Researche. 2010; 11: 169.
  15. Subagyo A, Aditama TY, Sutoyo DK, Partakusuma LG. Pemeriksaan interferon gamma dalam darah untuk deteksi infeksi tuberkulosis. Jurnal Tuberkulosis Indonesia. 2006; 3 (2): 6-19.
  16. Sastroasmoro S, Ismael S. Dasar-dasar metodologi penelitian klinis. edisi 3. Jakarta: Sagung Seto; 2008. hal. 147-65, 193-215.
  17. Quantikine Human IFN-Y Immunoassay. For the quantitative determinations in cell culture supernates, serum, and plasma. Catalog Number DIF 50. United States of America; R&D Systems Inc 614 McKinley place NE Minneapolis MN 55413.
  18. Karyorini, Suryanto E. Uji tuberkulin. Jurnal Tuberkulosis Indonesia. 2006; 3 (2): 6-19.
  19. Soysal A, Torun T, Efe S, Gencer H, Tahaoqlu K, Bakir M. Evaluation of cut off values of interferon gamma based assays in the diagnosis of m. tuberculosis infection. The International Journal of Tuberculosis and Lung Disease. 2008; 12 (1): 50-6.
  20. Sri AI. Pola sitokin TH1 dan TH2 pada penyandang tuberkulosis paru. Jurnal Visikes. 2009; 8 (1): 1412-3746.
  21. Lalvani A, Pareek M. A 100 year update on diagnosis of tuberculosis infection. Br Med Bull. 2010; 93: 69-84.
  22. Legesse M, Ameni G, Mamo G, Medhin G, Bjune G, Abebe F. Community based cross setional survey of latent tuberculosis infection in afar pastoralists Ethiopia using quantiferon TB gold in-tube and tuberculin skin test. BMC Infectious Disease. 2011; 11 (89).
  23. Wong CF, Yew WW, Leung SK, Chan CY, Hui M, Yeang CA, Cheung AF. Assay of pleural fluid interleukin-6, tumor necrosis factor alpha and interferon gamma in the diagnosis and outcome correlation of tuberculous

Download

Included in

Epidemiology Commons

Share

COinS