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Wafa Herviana
"Latar belakang: Pasien asma dapat mengalami sensitisasi terhadap Aspergillus sp. yang dapat menyebabkan aspergilosis bronkopulmoner alergika (ABPA). Kondisi ABPA, penggunaan steroid, dan kerusakan fungsi paru dapat meningkatkan risiko aspergilosis paru kronik (APK). Pemeriksaan baku emas mikologi APK adalah kultur jamur, yang memerlukan sumber daya terlatih dan waktu lama. Pemeriksaan imunokromatografi (ICT) Aspergillus dengan mekanisme lateral flow assay yang mudah dilakukan dan memerlukan sampel sedikit dapat menjadi alternatif baru deteksi Aspergillus sp. pada pasien asma persisten.
Metode: Penelitian ini dilaksanakan pada Juni-November 2021, menyertakan 50 pasien asma persisten di RS Persahabatan yang direkrut pada penelitian sebelumnya. Bahan klinis terdiri atas 50 serum pasien untuk pemeriksaan ICT Aspergillus dan 15 sampel sputum untuk kultur jamur. Pemeriksaan dilakukan di laboratorium Departemen Parasitologi FKUI.
Hasil: Demografi 50 subjek didominasi perempuan (78%) dan rerata usia subjek 55,8 tahun (SD±13,14). Hasil positif ICT Aspergillus ditemukan pada 16% (8 subjek). Pertumbuhan 17 isolat Aspergillus didapatkan pada sputum yang berasal dari 11 pasien, terdiri atas: Aspergillus niger (8 isolat), Aspergillus sp. (5 isolat), Aspergillus flavus (3 isolat), dan Aspergillus terreus (1 isolat). Tiga pasien memiliki hasil positif pada kultur dan ICT Aspergillus. Delapan dari pasien dengan hasil kultur positif memiliki hasil ICT negatif, meski 4 di antaranya memiliki 2 isolat Aspergillus.
Kesimpulan: Pemeriksaan ICT Aspergillus menunjukkan hasil positif 16% pada 50 pasien asma yang diteliti. Kultur jamur pada sputum 11 dari 15 pasien menunjukkan pertumbuhan Aspergillus sebanyak 17 isolat, dengan spesies terbanyak A. niger. Tidak terdapat kaitan bermakna antara pemeriksaan ICT Aspergillus dengan hasil kultur jamur Aspergillus pada pasien asma persisten.

Introduction: Asthma patients can be sensitized to fungi, including Aspergillus sp. which can cause allergic bronchopulmonary aspergillosis (ABPA). The certain conditions such as ABPA, steroid consumption, and lung function disturbance can increase the risk of chronic pulmonary aspergillosis (CPA). The gold standard for mycology examination for CPA diagnosis is fungal culture, which is time-consumed and need special resources. Immunochromatography test (ICT) Aspergillus could be a new alternative for CPA diagnosis, including for asthma patients.
Method: There were 50 persistent asthma patients from Persahabatan General Hospital who were recruited in previous study. Fifty sera were tested for ICT Aspergillus and 15 sputum samples for fungal culture.
Result: Demography of 50 subjects was dominated by women (78%) and mean age was 55.8 years (SD±13.14). Positive ICT test result was 16%, and 17 Aspergillus isolated from sputum of 11 out of 15 patients, consisted of Aspergillus niger (8 isolates), diikuti Aspergillus sp. (5 isolates), Aspergillus flavus (3 isolates), and Aspergillus terreus (1 isolate). There were 3 patients with positive results in both ICT and Aspergillus culture. Eight patients with Aspergillus confirmation had negative ICT results, despite 4 out of 8 had 2 Aspergillus isolates.
Conclusion: Aspergillus ICT in this study showed a positivity rate of 16%. There were 17 Aspergillus isolates from the sputum of 11 out of 15 patients, with A. niger as the most common species. There was no significant relationship between Aspergillus ICT examination and fungal culture results in persistent asthmatic patients.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Skripsi Membership  Universitas Indonesia Library
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Alfianti Fauziah
"Latar belakang: Pasien asma persisten berisiko mengalami penyakit jamur paru, termasuk aspergilosis bronkopulmoner alergika (ABPA) dan aspergilosis paru kronik (APK). Deteksi IgG spesifik Aspergillus metode enzyme-linked immunosorbent assay (ELISA) merupakan pemeriksaan mikologi yang direkomendasikan untuk diagnosis APK. Metode baru yang lebih praktis adalah immunochromatography test (ICT) Aspergillus, tetapi data hasil pemeriksaan tersebut masih terbatas di Indonesia. Penelitian ini bertujuan untuk mengetahui nilai diagnostik ICT Aspergillus dibandingkan dengan metode ELISA pada pasien asma persisten.
Metode: Uji diagnostik dilakukan untuk mengetahui nilai diagnostik ICT Aspergillus dibandingkan dengan IgG spesifik Aspergillus metode ELISA. Bahan klinis berasal dari serum pasien asma persisten di RSUP Persahabatan pada tahun 2021 yang memenuhi kriteria inklusi. Deteksi antibodi kedua metode tersebut dilaksanakan di laboratorium Departemen Parasitologi FKUI untuk mengetahui proporsi, sensitivitas, spesifisitas, nilai duga positif dan negatif.
Hasil: Deteksi antibodi spesifik Aspergillus kedua metode dilakukan terhadap 50 serum pasien. Proporsi hasil positif ICT Aspergillus 16%, sedangkan ELISA 32%. Nilai diagnostik ICT Aspergillus dibandingkan ELISA menunjukkan sensitivitas 25%, spesifisitas 88,24%, nilai duga positif 50%, dan nilai duga negatif 71,43%.
Kesimpulan: Pemeriksaan ICT Aspergillus belum dapat direkomendasikan sebagai pemeriksaan standar diagnosis APK pada pasien asma persisten karena memiliki sensitivitas rendah

Introduction: Patients with persistent asthma are at risk of developing pulmonary mycoses, including allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). Aspergillus immunochromatography test (ICT) is a new practical method to detect Aspergillus-specific antibodies, but data on ICT results are still limited in Indonesia. This study aims to determine the diagnostic value of Aspergillus ICT compared to ELISA in persistent asthma patients.
Methods: Diagnostic tests were carried out to determine the diagnostic value of Aspergillus ICT. The antibody detection on the sera of persistent asthma patients at Persahabatan General Hospital in 2021 who met inclusion criteria was carried out in the laboratory of Parasitology Department, FMUI to determine the proportion, sensitivity, specificity, positive and negative predictive values.
Results: Detection of Aspergillus-specific antibodies was performed on 50 patient sera using ICT and ELISA. The proportion of positive results for Aspergillus ICT revealed 16%, while the ELISA 32%. The diagnostic value of Aspergillus ICT compared to ELISA showed a sensitivity of 25%, specificity of 88.24%, a positive predictive value of 50%, and a negative predictive value of 71.43%.
Conclusion: Aspergillus ICT could not be recommended as a standard examination for CPA diagnosis in persistent asthma patients due to its low sensitivity.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Skripsi Membership  Universitas Indonesia Library
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Nabilah Nurul Islami
"Latar belakang: Indonesia memiliki beban tuberkulosis (TB) paru tinggi. Aspergilosis paru kronik (APK) sering ditemukan pada pasien TB. Diagnosis APK menjadi tantangan di Indonesia karena keterbatasan sumber daya. Diperlukan alat diagnostik yang mudah, murah, dan memberikan hasil cepat dengan akurasi baik untuk membantu menegakkan diagnosis APK. Penelitian ini bertujuan untuk mengetahui nilai diagnostik ICT Aspergillus pada pasien TB paru.
Metode: Penelitian ini berdesain potong lintang dan merupakan bagian dari penelitian payung tentang diagnosis APK pada pasien TB paru di Jakarta. Serum pasien TB paru yang memenuhi kriteria inklusi diperiksa menggunakan ICT Aspergillus (LDBio, Diagnostics, Lyon, France) dan IgG Spesifik Aspergillus ELISA (Bordier affinity products, Crissier, Switzerland) sesuai protokol di Laboratorium Mikologi Departemen Parasitologi FKUI pada Februari-November 2021.
Hasil: Dari 105 subjek penelitian yang memenuhi kriteria inklusi, sebanyak 58,1% adalah laki-laki. Rerata usia pasien 47,1617,1 tahun. Proporsi hasil positif ICT Aspergillus adalah 10,5% dan IgG spesifik Aspergillus ELISA 43,8%. Sensitivitas ICT Aspergillus 23,9%, dengan spesifisitas 100%, nilai duga positif 100%, dan nilai duga negatif 62,8%.
Kesimpulan: Kemampuan diagnostik ICT Aspergillus belum optimal sebagai alat skrining, tetapi dapat dipertimbangkan sebagai alat diagnosis pasien TB paru suspek APK pada daerah dengan sumber daya terbatas.

ackground: Indonesia has high pulmonary tuberculosis (TB) burden. Chronic pulmonary aspergillosis (CPA) is common in pulmonary TB patients. Diagnosing CPA is challenging in Indonesia because of the limited resources available. A new rapid and robust diagnostic tool is needed. This research aims to evaluate the diagnostic value of the ICT Aspergillus in pulmonary TB patients.
Methods: This cross-sectional study is a part of the CPA diagnostic research of pulmonary TB patients. Pulmonary TB patients' serum fulfilling the inclusion criteria were assessed using ICT Aspergillus (LDBio, Diagnostics, Lyon, France) and Aspergillus-specific IgG ELISA (Bordier affinity products, Crissier, Switzerland) in Mycology Laboratory of Parasitology Department FMUI in February-November 2021.
Results: From 105 subjects included, the proportion of men 58,1% with 47,1617,1 years age means. The Aspergillus IgG was positive in 10,5% patients with ICT, and 43,8% with ELISA. The sensitivity of ICT Aspergillus was 23,9%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 62,8%.
Conclusion: ICT Aspergillus has a fair diagnostic capacity in pulmonary TB patients as screening tools for CPA. However, the usage of ICT Aspergillus as point-of-care test in limited-resource settings needs to be considered.
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Depok: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Skripsi Membership  Universitas Indonesia Library
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Ayu Saraswati
"Penyakit tuberkulosis (TB) paru sering mendasari aspergilosis paru kronis (APK). Diagnosis APK masih menjadi tantangan karena gejala klinis dan hasil pemeriksaan yang tidak khas serta data penelitian yang terbatas. Pemeriksaan immunochromatography test (ICT) Aspergillus dilaporkan bermanfaat dalam diagnosis cepat APK. Tujuan penelitian ini adalah mengetahui kaitan hasil ICT Aspergillus dengan karakteristik klinis pasien TB paru. Penelitian dengan desain potong lintang ini merupakan bagian penelitian sebelumnya tentang diagnosis APK di Indonesia dan berlangsung pada Februari–November 2021. Pemeriksaan ICT Aspergillus dilakukan di laboratorium Departemen Parasitologi FKUI sesuai protokol (LD Bio Diagnostics, Lyon, France).
Dari 89 pasien TB paru yang memenuhi kriteria inklusi, terdapat 50 pasien (56,2%) laki-laki. Sebanyak 42,6% pasien dalam rentang usia 45-64 tahun, 56,2% berpendidikan akhir SMP/SMA, dan 53,9% merupakan pekerja. Karakteristik klinis pasien TB paru dalam penelitian ini menunjukkan indeks massa tubuh (IMT) normal pada 36 pasien (40,4%). Penyakit asma didapatkan pada 3,4% pasien, penyakit paru obstruktif kronis (PPOK) 4,5%, diabetes mellitus (DM) 16,9%, hipertensi 6,7%, dan kanker paru 1,1%. Hasil pemeriksaan ICT Aspergillusmenunjukkan hasil positif pada 11 pasien (12,4%). Pada penelitian ini, didapatkan hubungan bermakna antara hasil pemeriksaan ICT Aspergillus dengan penyakit penyerta pada pasien TB paru, yaitu asma (p = 0,039).

Pulmonary tuberculosis (TB) is the most common underlying disease of chronic pulmonary aspergillosis (CPA). Diagnosing CPA is still a challenge because of no typical pathognomonic clinical symptoms and examination result. Aspergillus Immunochromatography Test (ICT) is reported to be useful for rapid diagnosis of CPA. This study was used to determine relation between the results of Aspergillus ICT and the clinical characteristics of pulmonary TB patients. This cross-sectional study was part of the previous research on CPA diagnosis in Indonesia. Aspergillus ICT examination was carried out in FKUI Department of Parasitology laboratory according to the protocol (LD Bio Diagnostics, Lyon, France).
From the 89 pulmonary TB patients who met the inclusion criteria, there were 56,2% male patients, 42,6% of patients are within 45-64 years old age range, 56,2% have a final education of middle/high school, and 53,9% are workers, and normal body mass index (BMI) in 36 patients (40,4%). Asthma was found in 3,4% of patients, 4.5% of chronic obstructive pulmonary disease (COPD), 16.9% of diabetes mellitus (DM), 6.7% of hypertension, and 1.1% of lung cancer. Aspergillus ICT showed positive results in 11 patients (12,4%) and were related to the asthma variable (p = 0,039) in statistical analysis.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Skripsi Membership  Universitas Indonesia Library
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Muhammad Ryan Fadillah
"Latar belakang: Tuberkulosis (TB) dapat menimbulkan komplikasi yang disebabkan oleh infeksi Aspergillus spp, yaitu Aspergillosis Paru Kronik (APK) pada kavitasi di paru. Enzyme-linked Immunosorbent Assay (ELISA) otomatis dan Uji Imunokromatografi (ICT) adalah dua dari metode-metode yang menunjang diagnosis klinis APK. Kedua metode tersebut mendeteksi antibodi Aspergillus spp. Keduanya memiliki keunggulan dan kekurangan masing-masing, namun belum ada studi yang membandingkan hasil dari performa diagnosis APK kedua uji tersebut pada pasien akhir pengobatan TB.
Metode: Penelitian ini bersifat deskriptif analitik dengan desain potong lintang. Pemeriksaan ELISA otomatis subjek memiliki ambang > 11,5 sebagai hasil positif. Pemeriksaan ICT subjek memiliki hasil positif jika terlihat garis pada masing-masing kolom T dan C, sedangkan hasil positif hanya terlihat satu garis pada kolom C.
Hasil: Jumlah subjek keseluruhan adalah 62 subjek dan diperoleh 20 (32,3%) subjek terdiagnosis APK. Hasil positif pemeriksaan ELISA otomatis adalah 27 (43,5%) subjek, sedangkan pemeriksaan ICT adalah 2 (3,2%) subjek. Sensitivitas dan spesifisitas ELISA otomatis masing-masing adalah 75% dan 71,43%, sedangkan ICT adalah 10% dan 100%.
Simpulan: ELISA otomatis memiliki performa diagnosis yang lebih baik dibandingkan ICT untuk diagnosis APK, namun ELISA otomatis masih belum tersedia secara adekuat di wilayah Indonesia sehingga penggunaan ICT tetap digunakan sebagai pemeriksaan APK.

Introduction: Tuberculosis (TB) can cause complications caused by Aspergillus spp infection, namely Chronic Pulmonary Aspergillosis (CPA) in cavitation of the lungs. Automated Enzyme-linked Immunosorbent Assay (ELISA) and Immunochromatography Test (ICT) are two of the methods that support the clinical diagnosis of CPA. Both methods detect Aspergillus spp. antibodies. Both have their advantages and disadvantages, but there is no study that compares the results of the diagnostic performance of the CPA of the two tests in patients at the end of TB treatment.
Methods: This research was analytic descriptive with a cross-sectional design. Automated ELISA examination of subjects had a threshold > 11.5 as a positive result. ICT examination of subjects had positive results if there was a line in each T and C columns, while positive results only showed one line in C column.
Results: The total number of subjects were 62 subjects and 20 (32.3%) subjects diagnosed with CPA. Subjects showed positive results of automated ELISA examination were 27 (43.5%) subjects, while ICT examinations were 2 (3.2%) subjects. The sensitivity and specificity of the automated ELISA were 75% and 71.43%, respectively, while the ICT was 10% and 100%.
Conclusion: Automated ELISA has better diagnostic performance than ICT for CPA diagnosis, but automated ELISA was not adequately available in the Indonesian region so ICT was still used as CPA examination.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Skripsi Membership  Universitas Indonesia Library
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Fira Nurhalizha Luthfie
"Latar belakang: Aspergilosis paru kronik (APK) merupakan komplikasi yang sering ditemukan pada pasien dengan riwayat tuberkulosis (TB) paru. Pemeriksaan serologi Aspergillus yang cepat dan sensitif dibutuhkan untuk mendiagnosis APK. Penelitian ini membandingkan pemeriksaan serologi ELISA otomatis dan tes imunokromatografi pada dalam mendeteksi antibodi spesifik Aspergillus pada pasien dengan riwayat TB paru.
Metode: Studi potong-lintang ini merupakan bagian dari penelitian payung tentang diagnosis APK pada pasien TB. Serum pasien diperiksa menggunakan ELISA otomatis dan tes imunokromatografi. Performa diagnosis diperoleh melalui perbandingan hasil pemeriksaan dengan diagnosis APK. Agreement antar tes dianalisis dengan
Hasil: Didapatkan 68 pasien pasca TB dengan median usia 34,5 (17-72) tahun. Sebanyak 24 pasien diadiagnosis APK (35,3%). Proporsi positif ELISA otomatis dan tes imunokromatografi sebesar 48,5% dan 2,9%. ELISA otomatis memiliki sensitivitas 91,7%, spesifisitas 75%, nilai duga positif 66,7%, dan nilai duga negatif  94,3%. Tes imunokromatografi memiliki sensitivitas 8,3%, spesifisitas  dan nilai duga positif 100%, serta nilai duga negatif 66,7%. Agreement antara kedua tes sangat rendah (kappa score: 0,062).
Kesimpulan: Pada pasien dengan riwayat TB paru, ELISA otomatis IgG spesifik Aspergillus dapat digunakan sebagai pemeriksaan penunjang APK di area dengan sumber daya mendukung. Sedangkan tes imunokromatografi dapat digunakan sebagai uji penapisan awal APK di daerah dengan keterbatasan sumber daya.

Introduction: Chronic pulmonary aspergillosis (CPA) is common in post TB patients. Faster and more sensitive Aspergillus serological examination is necessary for CPA diagnosis. This study compared automated ELISA and immunochromatography test for Aspergillus specific antibody detection in post pulmonary TB patients.
Method: This cross-sectional study is part of previous research on CPA diagnosis in tuberculosis. Patient’s sera were tested with automated ELISA and immunochromatography test. The results were compared to CPA diagnosis to obtain diagnostic performances. The agreement between tests was analyzed with Cohen’s kappa.
Result: There were 68 previous TB patients with median age 34,5 (17-72) years old. CPA was diagnosed in 24 patients (35,3%). The positive result of automated ELISA and immunochromatography test were 48,5% and 2,9%. Automated ELISA showed sensitivity of 97%, specificity of 75%, PPV of 66,7%, and NPV of 94,3%. The immunochromatography test showed sensitivity of 8,3%, specificity and PPV of 100%, and NPV of 66,7%. There was very low agreement between tests (kappa score: 0,062).
Conclusion: Automated ELISA Aspergillus specific IgG could be utilized for supporting CPA diagnosis in post TB patients, mainly in settings where resources are available. Immunochromatography test is applicable as an early screening tool for CPA detection in resource-constrained areas.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Skripsi Membership  Universitas Indonesia Library
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Nurul Amalia
"Latar belakang: Aspergilosis paru kronik (APK) merupakan penyakit paru destruktif yang bersifat progresif terutama disebabkan infeksi Aspergillus fumigatus. Penyakit ini dapat menjadi komplikasi infeksi tuberkulosis (TB) dan menyebabkan morbiditas serta mortalitas signifikan. Diagnosis APK masih menjadi tantangan karena gejala klinis tidak khas, serta belum ada alat diagnosis yang cepat dan akurat. Deteksi IgG Aspergillus berbasis lateral flow assay (LFA) menggunakan metode imunokromatografi (ICT) merupakan uji cepat dan sederhana untuk membantu diagnosis APK. Penelitian ini bertujuan untuk mengetahui hubungan uji ICT Aspergillus dengan karakteristik klinis dan radiologis APK pada pasien terkait TB paru.
Metode: Penelitian berdesain potong lintang ini dilaksanakan pada April 2019-Juli 2023 dan merupakan bagian dari penelitian sebelumnya tentang diagnosis APK di Indonesia. Serum pasien APK diperiksa di Laboratorium Mikologi Departemen Parasitologi FKUI untuk deteksi ICT Aspergillus, kemudian dilanjutkan dengan analisis hasil penelitian.
Hasil: Sebanyak 29 dari 54 (54%) serum pasien yang diteliti menunjukkan hasil uji ICT Aspergillus positif. Proporsi jenis kelamin perempuan (63%) lebih banyak dibandingkan laki-laki, sedangkan usia terbanyak 30-60 tahun (74%). Gejala klinis terbanyak adalah fatigue (57%), batuk ≥ 3 bulan (42%), hemoptisis (41%) diikuti sesak napas (24%), dan nyeri dada (20%). Adapun penyakit penyerta terbanyak adalah diabetes melitus (20%), penyakit kardiovaskular (11%), dan PPOK (9%). Gambaran radiologi paling dominan adalah kavitas (94%), diikuti infiltrat (72%), dan penebalan pleura (55%). Analisis statistik menunjukkan kaitan bermakna antara hasil ICT Aspergillus positif dengan gambaran radiologi berupa infiltrat, fibrosis parakavitas, fibrosis, efusi pleura, konsolidasi dan bronkiektasis (p <0,005). Hasil ICT Aspergillus tidak menunjukkan kemaknaan statistik dengan karakteristik klinis.
Simpulan: Deteksi IgG spesifik Aspergillus metode ICT pada 54 pasien APK pada penelitian ini menunjukkan hasil positif 54%. Pada penelitian ini hasil ICT Aspergillus menunjukkan kaitan bermakna secara statistik dengan gambaran radiologi, tetapi tidak menunjukkan kaitan bermakna dengan karakteristik klinis pasien.

Background: Chronic pulmonary aspergillosis (CPA) is a progressive, destructive lung disease mainly caused by Aspergillus fumigatus infection. The disease can be a complication of tuberculosis (TB) infection and cause significant morbidity and mortality. Diagnosis of CPA is still challenging because the clinical symptoms are not typical, and there are no fast and accurate diagnostic tools. Detection of IgG-specific Aspergillus using the immunochromatography (ICT) method is a quick and simple test to assist CPA diagnosis. The study aimed to determine the correlation between the ICT Aspergillus test and the clinical and radiological characteristics of CPA in TB-related patients.
Method: This cross-sectional study was carried out in April 2019-July 2023 and was part of a previous study on CPA diagnosis in Indonesia. All sera of CPA patients were examined at the Clinical Parasitology Laboratory, Faculty of Medicine Universitas Indonesia for ICT Aspergillus detection, followed by analysis of the study results.
Result: Twenty-nine of the 54 patient sera showed positive results of ICT Aspergillus. There were more female (76%) than male patients, with the majority aged 30–60 years (74%). The most common clinical symptoms were fatigue (57%), cough ≥3 months (42%), hemoptysis (41%), shortness of breath (24%), and chest pain (20%). The most common comorbidities were diabetes mellitus (20%), cardiovascular diseases (11%), and COPD (9%). The dominant of radiological features were cavities (94%), followed by infiltrates (72%), and pleural thickening (55%). The statistical analysis showed a significant correlation between positive ICT Aspergillus results and radiological features, including infiltrates, paracavity fibrosis, fibrosis, pleural effusion, consolidation, and bronchiectasis. However, the ICT Aspergillus did not show statistical significance with clinical characteristics.
Conclusion: The ICT Aspergillus detection in this study showed positive results of 54%. There was a significant correlation between ICT Aspergillus positive result with radiology features, but no significant correlation with clinical characteristics.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
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UI - Tugas Akhir  Universitas Indonesia Library
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Joshua Moses
"Latar belakang: Indonesia memiliki beban tuberkulosis yang tinggi. Kerusakan paru yang ditimbulkan mendasari terjadinya aspergillosis paru kronik (APK). Salah satu kriteria diagnosis APK ialah bukti keterlibatan Aspergillus. Mempertimbangkan keterbatasan kultur, deteksi antibodi ELISA menjadi modalitas alternatif. Penelitian ini bertujuan membandingkan performa diagnostik pemeriksaan IgG spesifik Aspergillus ELISA manual dan otomatis pada pasien riwayat TB paru. Metode: Penelitian potong lintang ini membandingkan pemeriksaan IgG spesifik Aspergillus ELISA manual Bordier dan ELISA otomatis Immulite menggunakan serum pasien dengan riwayat TB. Performa diagnostik dibandingkan dalam bentuk proporsi hasil positif, sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif. Hasil: Terdapat total 68 subjek, dengan median usia 34,5 tahun, proporsi lansia 11,76% dan proporsi laki-laki 42,65%. Proporsi hasil positif pemeriksaan IgG spesifik Aspergillus ELISA manual dan ELISA otomatis masing-masing 13,24% dan 48,53%. Pemeriksaan IgG spesifik Aspergillus ELISA manual memiliki sensitivitas 20,83%, spesifisitas 90,91%, nilai duga positif 55,56%, dan nilai duga negatif 67,80%. Pemeriksaan IgG spesifik Aspergillus ELISA otomatis menunjukkan sensitivitas 91,67%, spesifisitas 75%, nilai duga positif 66,67%, dan nilai duga negatif 94,29%. Kesimpulan: Performa diagnostik dan teknis pemeriksaan IgG spesifik Aspergillus ELISA otomatis lebih baik dibandingkan ELISA manual, tetapi pemilihan modalitas diagnosis perlu mempertimbangkan faktor keterjangkauan, aksesibilitas, dan akurasi sesuai kebutuhan dan ketersediaan sumber daya.

Introduction: Indonesia has high tuberculosis (TB) burden. The resulting lung damage underlies chronic pulmonary aspergillosis (CPA) development. CPA is diagnosed in patients with evidence of Aspergillus involvement as one of its criteria. Taking into account the limitations of culture, ELISA antibody detection becomes alternative modality. This study aims to compare diagnostic performance between manual and automated ELISA for Aspergillus-specific IgG in patients with treated TB. Method: This cross-sectional study compares Aspergillus-specific IgG test using Bordier manual ELISA and Immulite automated ELISA on sera from patients with treated TB. Diagnostic performance was compared in positive test proportion, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV). Result: There are 68 subjects, with median age of 34,5 years, elderly subjects proportion of 11,76%, male proportion of 42,65%. Positive results proportion from Aspergillus-specific IgG manual and automated ELISA are 13,24% and 48,53%, respectively. Manual ELISA shows 20,83% sensitivity, 90,91% specificity, 55,56% PPV, 67,80% NPV. Automated ELISA shows 91,67% sensitivity, 75% specificity, 66,67% PPV, 94,29% NPV. Conclusion: Technical and diagnostic performance of automated ELISA Aspergillus-specific IgG test is better than manual ELISA, but choosing diagnostic modality needs consideration on factors such as affordability, accessibility, and accuracy according to the needs and available resources."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Skripsi Membership  Universitas Indonesia Library
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Dimas Muhammad Adli Dwinayoga
"Tuberkulosis merupakan salah satu masalah Kesehatan di dunia. Di Indonesia sendiri perkiraan total kejadian sebesar 312 per 100.000 penduduk dan dengan angka 34 kematian per 100.000 populasi TB. Kerusakan jaringan paru pada pasien yang terkena TB mampu mengakibatkan ko-infeksi dengan mikroorganisme lain seperti mikosis paru. Mikosis paru yang umum ditemukan disebabkan oleh Aspergillus, dan akan menyebabkan aspergilosis paru. Terdapat beberapa pemeriksaan serologi yang dijadikan rekomendasi dalam membantu mendiagnosis APK yaitu ELISA dan Imunokromatografi. Tujuan penelitian ini adalah membandingkan performa serta menganalisis keuntungan dan kerugian kedua pemeriksaan tersebut dalam membantu mendiagnosis APK pada pasien TB aktif
Metode: Penelitian ini bersifat deskriptif analitik dengan menggunakan metode potong lintang. Data yang diperoleh dan diolah merupakan data sekunder berjumlah 67 subjek yang berisikan usia, jenis kelamin, serta hasil dari kedua metode ELISA dan ICT. Analisis yang dilakukan mengenai perbandingan antara hasil pemeriksaan ELISA otomatis dengan imunokromatografi. Hasil pemeriksaan ELISA responden berdasarkan cut off >11,5 merupakan hasil positif dan cut off
Hasil: Dari 67 subjek secara keseluruhan didapatkan 15 (22,4%) subjek yang terdeteksi positif pada kedua metode pemeriksaan. Jika diuraikan lebih spesifik, dengan pemeriksaan ELISA didapatkan 14 (20,8%) subjek yang terdeteksi positif dan hanya 1 (1,5%) subjek yang terdeteksi positif dengan pemeriksaan imunokromatografi. Pemeriksaan serologi ELISA otomatis Immulite memiliki sensitivitas sebesar 64,3% dan spesifisitas 88,7%. Pemeriksaan imunokromatografi memiliki sensitivitas dan spesifisitas sebesar 33,33% dan 88% secara berturut-turut.
Kesimpulan: Performa diagnostik ELISA otomatis lebih baik dibandingkan imunokromatografi, namun dikarenakan fasilitas ELISA yang belum tersedia di sebagian besar wilayah di Indonesia, penggunaan imunokromatografi dapat digunakan sebagai pemeriksaan penapis untuk APK.

Tuberculosis is a global health problem. In Indonesia alone, the estimated total incidence is 312 per 100,000 population and with 34 deaths per 100,000 TB population. Lung tissue damage in patients affected by TB can result in co-infection with other microorganisms such as pulmonary mycoses. Commonly found pulmonary mycoses are caused by Aspergillus, and will lead to pulmonary aspergillosis. There are several serological tests that are recommended to help diagnose APK, namely ELISA and Immunochromatography. The aim of this study was to compare the performance and analyse the advantages and disadvantages of the two tests in helping to diagnose APK in active TB patients.
Method: This study is descriptive analytic using the cross-sectional method. The data obtained and processed were secondary data totalling 67 subjects containing age, gender, and results from both ELISA and ICT methods. The analysis was carried out regarding the comparison between the results of automatic ELISA examination with immunochromatography. The results of the respondent's ELISA examination based on the cut off >11.5 is a positive result and the cut off Results: Out of 67 subjects in total, 15 (22.4%) subjects were detected positive in both examination methods. If described more specifically, with ELISA examination, 14 (20.8%) subjects were detected positive and only 1 (1.5%) subject was detected positive with immunochromatographic examination. Immulite automated ELISA serological examination had a sensitivity of 64.3% and specificity of 88.7%. Immunochromatographic examination had a sensitivity and specificity of 33.33% and 88% respectively.
Conclusion: The diagnostic performance of automated ELISA is better than immunochromatography, but since ELISA facilities are not yet available in most parts of Indonesia, immunochromatography can be used as a screening test for CPA.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Skripsi Membership  Universitas Indonesia Library
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Reihana Zahra
"Latar belakang: Aspergilosis paru kronik (APK) merupakan komplikasi yang sering menyebabkan munculnya sekuela respiratori pada pasien bekas tuberkulosis (TB) paru. Diagnosis APK dapat dilakukan dengan pemeriksaan serologi IgG spesifik Aspergillus. Metode tersebut memerlukan waktu tertentu, sumber daya, dan fasilitas khusus, sehingga sulit diterapkan di fasilitas kesehatan dengan sumber daya terbatas. Metode baru Immunocromatography Test (ICT) LD Bio Aspergillus dilaporkan lebih mudah digunakan, cepat dan murah; tetapi akurasi diagnostiknya belum diketahui di Indonesia.
Tujuan: Penelitian ini bertujuan untuk mengetahui akurasi diagnostik LD Bio ICT Aspergillus dibandingkan dengan IgG spesifik Aspergillus pada pasien bekas TB.
Metode: Penelitian dengan desain potong lintang ini dilakukan dari April 2019 – Oktober 2020. Perekrutan subjek dilakukan di RSUP Persahabatan dan prosedur pemeriksaan mikologi dilakukan di Laboratorium Parasitologi FKUI. Serum pasien bekas TB diperiksa menggunakan LD Bio ICT Aspergillus dan IgG spesifik Aspergillus Dynamiker ELISA. Hasil kedua pemeriksaan dibandingkan untuk melihat akurasi diagnosis LD Bio ICT.
Hasil: Dari 82 pasien yang sesuai dengan kriteria inklusi, terdapat 57 pasien (69,5%) laki-laki, rerata usia pasien 51,27±12,55 tahun. Median IMT 18,67 (10,38-31,18). Sebanyak 40 pasien (48,7%) menunjukkan hasil positif IgG spesifik Aspergillus. Adapun hasil positif LD Bio ICT Aspergillus didapatkan pada 35 pasien (42,7%). Sensitivitas dan spesifisitas LD Bio ICT dibandingkan dengan pemeriksaan IgG spesifik Aspergillus adalah 50,0% dan 64,3%, sedangkan nilai duga positif dan negatifnya adalah 57,1% dan 57,5%.
Simpulan: LD Bio ICT dapat digunakan untuk mendiagnosis APK pada pasien bekas TB Paru di fasilitas kesehatan dengan sumber daya terbatas.

Background: Chronic pulmonary aspergillosis (CPA) is a common complication following prior pulmonary tuberculosis (TB) causing respiratory sequelae. Although CPA may lead to worse prognosis, it is still underdiagnosed. Serology test such as Aspergillus-specific IgG is the recommended test for CPA diagnosis. However, this diagnostic procedure is time-consuming, require a lot of resources and certain skills, making this procedure not always easy to implement in limited facilities. The LDBio Diagnostic introduced a novel, affordable, and easy to use serology test, LD Bio Immunocromatography Test (ICT). Nevertheless, LD Bio ICT’s diagnostic accuracy in Indonesia is still unknown.
Study aims: This study aimed to determine the diagnostic accuracy of LD Bio ICT with Aspergillus-specific IgG as comparison in previous pulmonary TB patients.
Methods: This cross-sectional study was conducted in April 2019 – October 2020. Subject recrutment was done in National Referral Centre Persahabatan Hospital and serological test was conducted in the Parasitology Laboratory, Faculty of Medicine Universitas Indonesia. Eighty two sera of previous pulmonary TB patients were serologically tested using LD Bio ICT Aspergillus (France) and Aspergillus-specific IgG was tested using Dynamiker ELISA kit. Results of both tests were then compared to determine the diagnostic accuracy of LD Bio ICT.
Results: Of 82 patients met the inclusion criteria, 57 patients (69.5%) were men, the mean age was 51.27±12.55 years old. The BMI median was 18.67 (10.38-31.18). Forty patients (48.7%) showed positive Aspergillus-specific IgG Dynamiker results. Meanwhile, 35 patients (42.7%) showed positive results of LD Bio ICT Aspergillus. Compared to this finding, LD Bio ICT sensitivity and specificity were 50.0% and 64.3% respectively. In addition, the positive and negative prediction value of LD Bio ICT in this study were 57.1% and 57.5%.
Summary: LD Bio ICT is useful for the diagnosis of CPA in previous pulmonary TB patients in resource-limited settings.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Skripsi Membership  Universitas Indonesia Library
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