"Diagnosis Dini Tuberkulosis pada Kontak Serumah dengan Penderita Tuber" by Sri Andarini Indreswari and Suharyo Suharyo
 

Abstract

Tuberkulosis paru masih merupakan masalah dunia. Indonesia menempati peringkat ke tiga di dunia pada tahun 2012. Target nasional Case Detection Rate tahun 2012 adalah 70%, sedangkan pencapaian Jawa Tengah sebesar 58,48%. Penelitian ini bertujuan untuk memperoleh batas kadar interferon (IFN) γ pada orang kontak serumah dengan penderita tuberkulosis paru sebagai dasar diagnosis dini penyakit tuberkulosis. Penelitian dilakukan secara kohort selama dua tahun (2011 - 2013) di Balai Kesehatan Masyarakat Paru Semarang. Pada akhir penelitian, terdapat 12 responden kontak dan 13 tidak kontak serumah. Uji Wilcoxon menunjukkan perbedaan bermakna rerata kadar IFN-γ antara kelompok kontak dengan kelompok tidak kontak serumah (nilai p = 0,004). Rerata kadar IFN-γ pada kontak serumah mengalami penurunan pada sebagian besar kasus (75%). Pada kelompok kontak serumah, 25% menunjukkan gejala klinis suspek tuberkulosis paru. Pemeriksaan mikrobiologis menunjukkan 100% negatif pada kedua kelompok. Hasil reciever operating characteristic kadar IFN-γ terhadap status klinis, diperoleh nilai area under the curve sebesar 70,4% (95% CI= 40,8% - 99,9%). Nilai cut off point IFN-γ yang optimal secara statistik yaitu pada nilai ≥3,277. Diperoleh hasil sensitivitas dan spesifisitas sebesar 67,7%. Pemeriksaan kadar IFN-γ dapat digunakan dalam kegiatan skrining untuk mendeteksi secara dini penularan pada kontak serumah dengan penderita tuberkulosis paru, sebagai pilot project pada daerah dengan prevalensi tuberkulosis paru yang tinggi. Tuberculosis remains a global problem. In 2012, Indonesia has the third biggest tuberculosis cases in the world. The national target in Case Detection Rate for tuberculosis in 2012 was 70%, whereas Jawa Tengah reached only 58.48%. This research aimed to find interferon (IFN) g level among households contact with tuberculosis patient that used a new screening method of finding tuberculosis cases. The research design was a two-year cohort study (2011 - 2013) took place in pulmonary community health centers Semarang. In the end of research, found 12 participants household contact and 13 participants nonhousehold contact. Wilcoxon test result showed significant differences IFN-g level between contact group and noncontact group (p value= 0.004). IFN-g among household contact group decreased in most cases (75%). Among household contact group showed 25% had a clinical symptom of tuberculosis. Microbiology diagnostic showed 100% had negative result in both group. Result of receiver operating characteristic IFN-g level toward clinical status, had value area under curve 70.4% (95% CI= 40.8%-99.9%). Cut off point of IFN-g value have optimal result in ³3.277, with sensitivity and specificity value 67.7%. IFN-g level test can be used in screening program to early detection of infected among household contact with new tuberculosis cases, as a pilot project in high prevalence of new tuberculosis cases.

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