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"[ABSTRAKPendahuluan: Pekerja penyamakan kulit berpotensi terpajan oleh berbagai polutan pencemar udara, salah satunya kromium. Terhirupnya polutan kromium dapat mempengaruhi kesehatan seperti sesak nafas, batuk, penurunan fungsi paru, hingga kanker paru. Tujuan: Untuk mengetahui hubungan pajaran konsentrasi kromium di tempat kerja dengan gangguan fungsi paru. Metode: Penelitian ini menggunakan desain studi cross sectional terhadap 61 orang pekerja penyamakan kulit di Sukaregang Kabupaten Garut. Kapasitas vital paksa (FVC) dan volume ekpirasi paksa satu detik (FEV1) diukur menggunakan spirometri Datospris mod 120 Sibelmed. Kromium total di tempat kerja diukur menggunakan low volume sampler dan dianalisis menggunakan atomic absorbtion spectrofotometry (AAS). Hasil: konsentrasi kromium total di tempat kerja berkisar antara 3.94-11.79 μg/m3. Kondisi fungsi paru pekera penyamakan kulit sebagaian besar masih besar masih dalam keadaan normal (FEV1/FVC>75%). Analisis multivariat menunjukkan bahwa masa kerja dan pajanan debu kromium meningkatkan risiko tejadinya fungsi paru pada pekerja, (p 0.024) dengan 95% CI (0.086-0.830). Kesimpulan: setelah dikontrol dengan masa kerja, pekerja yang terpajan kromium lebih besar, berisiko terkena gangguan fungsi paru.

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ABSTRACTBackground: tannery workers have been potentially exposed to various air pollutants, such as chromium. Exposed by chromium can affect health status, such as shortness of breath, cough, decreased lung function, and lung cancer. Objective: to determine the relationship of chromium exposure in the workplace and worker?s pulmonary dysfunction. Method: this study used a cross-sectional design on 61 people working at tanneries in Sukaregang, Garut district. Lung function was measured by spirometry. Low volume of sample was used to measure the chromium in the air and analyzed using atomic absorbtion spectrofotometry (AAS). Result: the concentration of total chromium in the workplace ranged from 3.94-11.79 μg/m3, while most of worker?s pulmonary function still in normal condition. Multivariate analysis showed that length of exposure and chromium concentration increases the risk of pulmonary dysfunction in tannery workers, (p 0.024 95% CI 0.068-0.830). Conclusion: control by lenght of exposure showed tannery worker who expose to higher concentration of chromium, have more risk to get pulmonary dysfunction.;Background: tannery workers have been potentially exposed to various air pollutants, such as chromium. Exposed by chromium can affect health status, such as shortness of breath, cough, decreased lung function, and lung cancer. Objective: to determine the relationship of chromium exposure in the workplace and worker?s pulmonary dysfunction. Method: this study used a cross-sectional design on 61 people working at tanneries in Sukaregang, Garut district. Lung function was measured by spirometry. Low volume of sample was used to measure the chromium in the air and analyzed using atomic absorbtion spectrofotometry (AAS). Result: the concentration of total chromium in the workplace ranged from 3.94-11.79 μg/m3, while most of worker?s pulmonary function still in normal condition. Multivariate analysis showed that length of exposure and chromium concentration increases the risk of pulmonary dysfunction in tannery workers, (p 0.024 95% CI 0.068-0.830). Conclusion: control by lenght of exposure showed tannery worker who expose to higher concentration of chromium, have more risk to get pulmonary dysfunction., Background: tannery workers have been potentially exposed to various air pollutants, such as chromium. Exposed by chromium can affect health status, such as shortness of breath, cough, decreased lung function, and lung cancer. Objective: to determine the relationship of chromium exposure in the workplace and worker’s pulmonary dysfunction. Method: this study used a cross-sectional design on 61 people working at tanneries in Sukaregang, Garut district. Lung function was measured by spirometry. Low volume of sample was used to measure the chromium in the air and analyzed using atomic absorbtion spectrofotometry (AAS). Result: the concentration of total chromium in the workplace ranged from 3.94-11.79 μg/m3, while most of worker’s pulmonary function still in normal condition. Multivariate analysis showed that length of exposure and chromium concentration increases the risk of pulmonary dysfunction in tannery workers, (p 0.024 95% CI 0.068-0.830). Conclusion: control by lenght of exposure showed tannery worker who expose to higher concentration of chromium, have more risk to get pulmonary dysfunction.]"

"[Particulate Matter (PM) terutama partikel <2,5 μg/m3 atau PM2.5, adalahkomponen utama yang terkandung dalam asap dari bahan bakar biomassa. Efekyang terkait dengan paparan jangka panjang PM2,5 meliputi peningkatan gejalapernapasan bagian bawah, penyakit paru obstruktif kronik dan penurunan fungsiparu. Salah satu pengguna bahan bakar biomassa yang cukup tinggi di SumateraBarat adalah usaha rumah makan, tujuan dari penelitian ini menganalisis asosiasifaktor lingkungan dengan konsentrasi PM2,5 pada waktu masak di dapur rumahmakan Kota Solok dan menganalisis konsentrasi PM2,5 pada waktu masak denganfungsi paru pekerja dapur rumah makan. Penelitian ini adalah penelitian dekriptifanalitik dengan menggunakan desain studi cross-sectional, dengan jumlah sampeladalah 71 orang (total sampling). Analisis multivariat hubungan faktor lingkungandengan PM2,5 pada waktu masak didapatkan hubungan signifikan ventilasi OR:5,655 (95% CI: 0,780 ? 40,994) dan lama waktu masak OR: 12,013, (CI: 1,113 ?129,714). Analisis multivariat hubungan PM2,5 pada waktu masak dengangangguan fungsi paru, yaitu PM2,5 OR: 3,60 (CI: 95%, 0,921 ? 14,072), UmurOR: 1,443, (CI 95%, 0,380 ? 5,477), dan masa kerja OR: 13,854, (95% CI: 3,283? 58,388). Terdapat hubungan bermakna antara faktor lingkungan dengankonsentrasi PM2,5 pada waktu masak yaitu variabel lama masak dan ventilasi.Sedangkan untuk konsentrasi PM2,5 pada waktu masak ada hubungan yangbermakna dengan gangguan fungsi paru pekerja dapur dengan dikontrol olehumur dan masa kerja;Particulate Matter (PM), particularly inhalable particulate ( <2,5 μm), isthe main components in biomass emission. Long term exopusre of PM2,5 hadbeen proved to increase lower respiratory disorder, chronic obtructive pulmonarydisease (COPD), and decrease lung function. Padang Restaurant is one of themain user of biomass fuel in west sumatera. The aim of this research was toanalize the association of PM2,5 concentration during cooking and lung functiondisorder among restaurant kitchen workers. This was a cross-sectional study with71 workers were included. There was a significant association between PM2,5and ventilation OR: 5,655 (95% CI: 0,780 ? 40,994) and cooking duration OR:12,013, (CI: 1,113 ? 129,714). Multivariate analysis between PM2,5 and lungfunction disorder showed significant association, PM2,5 OR: 3,60 (CI: 95%, 0,921? 14,072), age OR: 1,443, (CI 95%, 0,380 ? 5,477), and working durationOR: 13,854, (95% CI: 3,283 ? 58,388). There was a significant associationbetween environmental factors (ventilation and cooking duration) and PM2,5concentration during cooking. Meanwhile PM2,5 concentration and lung fuctionshowed significant association after controled by age and working duration., Particulate Matter (PM), particularly inhalable particulate ( <2,5 μm), isthe main components in biomass emission. Long term exopusre of PM2,5 hadbeen proved to increase lower respiratory disorder, chronic obtructive pulmonarydisease (COPD), and decrease lung function. Padang Restaurant is one of themain user of biomass fuel in west sumatera. The aim of this research was toanalize the association of PM2,5 concentration during cooking and lung functiondisorder among restaurant kitchen workers. This was a cross-sectional study with71 workers were included. There was a significant association between PM2,5and ventilation OR: 5,655 (95% CI: 0,780 – 40,994) and cooking duration OR:12,013, (CI: 1,113 – 129,714). Multivariate analysis between PM2,5 and lungfunction disorder showed significant association, PM2,5 OR: 3,60 (CI: 95%, 0,921– 14,072), age OR: 1,443, (CI 95%, 0,380 – 5,477), and working durationOR: 13,854, (95% CI: 3,283 – 58,388). There was a significant associationbetween environmental factors (ventilation and cooking duration) and PM2,5concentration during cooking. Meanwhile PM2,5 concentration and lung fuctionshowed significant association after controled by age and working duration.]"

"Tingkat paparan benzo[a]pyrene (BaP) salah satu senyawa PAH pada polusi udara dapat dihitung dengan menggunakan metode Hemoglobin-Adduct. Responden terpilih ialah polantas (individu berisiko tinggi), polisi administrasi (individu berisiko rendah), dan pasien kanker (individu yang diduga telah mengalami paparan). Produk hidrolisis asam yang dilakukan pada globin (sampel darah) ialah hidrolisat BaP-adduct berupa senyawa benzo[a]pyrene tetrahydrotetrol (BaPT), dan dianalisis dengan HPLC-Fluoresensi fasa terbalik kolom RP-18, eluen metanol-air (55:45). Hasil uji validasi metode ialah batas deteksi (LOD) dalam penelitian ini mencapai 0,31 pg/mg globin dan batas kuantifikasi (LOQ) ialah 1,03 pg/mg globin. Konsentrasi adduct BaPT pada polantas berkisar 1,36 ? 7,38 pg/mg globin, pada polisi bagian administratif berkisar 0,01 ? 1,85 pg /mg globin, sedang adduct pada pasien kanker paru berkisar 2,58 ? 50,94 pg /mg globin. Disimpulkan bahwa terdapat peranan paparan BaP dalam polusi udara terhadap tingginya tingkat konsentrasi B[a]P Hb-Adduct yang diperoleh. "

"ABSTRAKLatar belakang: Pekerja di perusahaan alat berat terutama bagian pengelasan dapat terpajan berbagai macam logam berbahaya yang terdapat pada plat yang digunakan. Salah satu logam yang dapat menyebabkan kerusakan sel bahkan dapat menyebabkan kanker adalah kromium. Hati merupakan salah satu target organ dan sering mengalami kerusakan akibat logam ini. Tujuan penelitian ini adalah mencari hubungan kadar kromium di dalam eritrosit dengan status fungsi hati pekerja.Metode: Penelitian potong lintang komparasi dilakukan terhadap pekerja yang terpajan dengan pekerja yang tidak terpajan. Data yang digunakan berdasarkan hasil pengukuran fisik, hasil pengukuran kromium eritrosit dan Serum Glutamic Pyruvic Transaminase (SGPT), serta hasil kuisioner.Hasil: Dari 50 pekerja yang terbagi menjadi 25 orang terpajan dan 25 orang tidak terpajan, terdapat hubungan bermakna secara statistik antara kadar kromium eritrosit dengan masa kerja (p=0,044). Tidak terdapat hubungan bermakna secara statistik antara kadar kromium di dalam eritrosit dengan SGPT (p=0,814).Kesimpulan: tidak terdapat hubungan bermakna secara statistik mengenai hubungan kadar kromium dengan kadar SGPT. Namun hasil rerata kadar kromium pekerja tidak terpajan lebih tinggi daripada populasi normal lainnya.

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ABSTRACT

Background: worker in heavy equipment manufacturer especially can be exposed to a various kinds of harmful metals contained in the plate. One of metal that can cause cell damage or even cancer which are often used in workplace is chromium. Liver is one of targeted organ could be damaged due to this metal. The purpose of this study is to correlate between chromium level in erythrocytes and welder?s liver function status.

Methods: A Cross Sectional Comparative study was conducted to workers who were exposed and unexposed. The data used is based on worker?s physical measurement result, chromium level erythrocytes and Serum Glutamic Pyruvic Transaminase (SGPT) results, and also questionnaire.

Results: From 50 workers which are consisted of 25 exposed workers and 25 unexposed workers, there is statistically significant correlation between chromium erythrocytes level and duration of employment (p=0,044). There is no statistically significant correlation between chromium level in erythrocytes and SGPT (p=0.814).

Conclusion: There is no statistically significant correlation between erythrocytes chromium level and SGPT level. But the average result of erythrocytes chromium level of the unexposed workers were higher compare to other normally unexposed workers."

"Latar belakang. PM2.5 dikenal sebagai salah satu faktor lingkungan yang paling berpengaruh terhadap beban kematian global. Pabrik dengan bahan baku semen merupakan kontributor utama dalam emisi PM tingkat global. Emisi PM2.5 dapat menurunkan fungsi paru manusia yang mengakibatkan PPOK. Oleh karena itu penelitian ini dilakukan untuk melihat hubungan antara pajanan PM2.5 dengan risiko PPOK pada pekerja. Metode. Penelitian ini menggunakan desain studi cross-sectional dengan data primer. Jumlah sampel penelitian sebanyak 84 pekerja, metode pengambilan sampel lingkungan menggunakan metode personal sampling, sedangkan sampel responden diambil menggunakan purposive sampling. Instrumen yang digunakan adalah kuesioner IPAG untuk skrining PPOK dan Laser Egg untuk mengukur konsentrasi PM2.5. Hasil. Berdasarkan hasil uji Chi-square terdapat hubungan yang signifikan antara konsentrasi PM2.5 OR = 3,627; 95 CI: 1,190-11,055 dan lama kerja OR = 0,352; 95 CI: 0,144-0,858 . Dari hasil uji regresi logistik ditemukan faktor paling dominan terhadap PPOK adalah konsentrasi PM2.5 OR = 4,000 dan lama kerja sebagai variabel protektif OR = 0,323. Simpulan. Konsentrasi PM2.5 merupakan variabel yang berpotensi untuk menyebabkan PPOK, sedangkan lama kerja menjadi variabel protektif terhadap kejadian PPOK.

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Background. PM2.5 is known as one of the most influential environmental agent to the global death burden. Cement plants are major contributors to global level PM emissions. PM2.5 emissions can decrease human lung function resulting in COPD. Therefore, this study was conducted to see the relationship between PM2.5 exposure and the risk of COPD on workers.

Methods. Cross sectional study using primary data with personal sampling method for the environmental agent. Subjects in this study are 84 workers taken using purposive sampling. Instrument used was Laser Egg to measure PM2.5 concentration and IPAG questionnaire for COPD screening.

Results. Bivariate analysis shows PM2.5 concentration OR 3,627 95 CI 1,190 11,055 and years of working OR 0,352 95 CI 0,144 0,858 as variables that significantly related with COPD. The result from logistic regression test found the most dominant factor for COPD is the concentration of PM2.5 OR 4 and years of working as a protective variable OR 0,323. Conclusion. PM2.5 concentration is a potential variable to cause COPD whereas the years of working comes protective variable against COPD occurence."

"Latar belakang penelitian: Polisi lalu lintas merupakan pekerjaan yang sehari-hari berada di jalan. Pajanan polusi udara jalan raya akibat kendaraan bermotor meningkatkan risiko kesehatan khususnya kelainan faal paru. Walaupun sudah banyak penelitian mengenai hubungan nilai faal paru dengan polutan, namun belum ada penelitian mengenai gambaran foto toraks dan kadar CO ekspirasi polisi lalu lintas Jakarta Barat tahun 2012. Metode penelitian :). Studi potong lintang dilakukan pada 107 anggota polisi LALULINTAS yang masuk dalam kriteria inklusi. Pemeriksaan status kesehatan mencakup anamnesis dan wawancara singkat dengan Kuesioner berdasarkan Pneumobile Project Indonesia dan pertanyaan lain tentang kebiasaan menggunakan APD masker, anamnesis dan pemeriksaan fisis serta status kesehatan. Selain itu diperiksa nilai faal paru menggunakan spirometri dan kadar CO ekspirasi dengan CO analyzer. Analisis statistik dilakukan menggunakan SPSS PC software version 17. Hasil : Sebagian besar responden, 80 responden (74,8%), tidak memiliki kelainan faal paru (normal) dan 27 responden (25,2%) terdapat gangguan restriksi ringan, obstruksi ringan dan gangguan obstruksi sedang. Foto toraks responden 100% dalam batas normal. Nilai p untuk hubungan antara umur, indeks massa tubuh, kebiasaan merokok, pemakaian masker dan masa kerja dengan gangguan faal paru adalah p>0.05. Kesimpulan : Tidak ada hubungan yang bermakna antara umur, indeks massa tubuh, kebiasaan merokok, pemakaian masker dan masa kerja dengan gangguan faal paru.

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Background research : Traffic police is the day-to-day work on the road. Exposure to air pollution due to highway motor vehicles increases health risks especially pulmonary function abnormalities. Although many studies on the relationship of lung function values by pollutant, but there is no research on the radiographic image and expiratory CO levels in West Jakarta traffic police in 2012.

Methods: Cross-sectional study conducted in 107 traffic policemen in the inclusion criteria. Examination of the history and health status includes a short interview with a questionnaire based Pneumobile Project Indonesia and other questions about the habit of using PPE masks, history and physical examination and health status. Moreover examined lung function using spirometry values and expiratory CO levels by CO analyzer. Statistical analysis was performed using SPSS version 17 software PC.

Results: Most respondents, 80 respondents (74.8%), did not have lung function abnormalities (normal) and 27 respondents (25.2%) disorders are mild restriction, obstruction light and moderate obstruction interference. 100% of respondents CXR within normal limits. P value for the relationship between age, body mass index, smoking habits, use of masks and years of impaired lung function is p> 0.05.

Conclusion: There is no significant relationship between age, body mass index, smoking habits, use of masks and years of impaired lung function."

"Aktifitas pekerjaan sektor meubel banyak menghasilkan debu kayu sebagai efek samping dari proses pekerjaan. Kegiatan meubel di sektor informal kel Kahuripan sebagian besar dilaksanakan di pemukiman dan tempat kerja yang tidak terpisah dari rumah tinggal. Hal ini bisa menimbulkan gangguan kesehatan terutama pada kelompok balita. Tujuan penelitian ini adalah untuk menganalisis kadar debu di lingkungan pemukiman dengan gangguan kesehatan pada balita. Metode penelitian menggunakan pendekatan cross sctional. Sampel sebanyak 51 orang diambil dari populasi sebanyak 126 orang balita. Hasil pengukuran kadar debu di lingkungan pemukiman menunjukan 74,5% tempat tinggal balita mempunyai kadar debu melebih standar, kadar debu berkisar antara 52 µg/Nm3 sampai 1508 µg/Nm3 . Sebanyak 30 balita (58,8%) mengalami gangguan kesehatan berupa kejadia infeksi saluran pernapasan. Hasil analisis Chi-square (p< 0,05) menunjukan ada hubungan antara kualitas udara permukiman dengan kejadian ISPA pada balita di sekitar industri mebeul kelurahan Kahuripan kota Tasikmalaya. Disarankan agar masyarakat membuat sekat pemisah antara rumah tinggal dengan ruangan tempat pengerjaan meubel. "

"Loading and unloading activity at port of Boom Baru in Palembang reached mean number 8264.892 ton each year. This caused happening of particulate contamination which can cause of the occurrence of non infection bronchi trouble. This study aim is to know PM10 exposure to occurrence of non infection bronchi trouble for loading and unloading worker at Port of Boom Baru in Palembang.In this study, variables of temperature, dampness and wind velocity are studied and their effect for PMI0 concentration, while variables of PM10 concentration, age, work time, nutrition status, smoking habit and usage of self protective device (APD) are checked and their effect for the occurrence of non infection bronchi trouble. PM1o concentration is used for analyzing effect of particulate contamination for the occurrence of non infection bronchi trouble.This study used a retrospective cohort study design for calculating Relative Risk (RR) to occurrence of non infection bronchi trouble as result of PM1o exposure and also another factors. Data analysis which has been done consisting of univariate analysis (descriptive), bivariate (kai square test and t-test) and multivariate (multiple linear regression and multiple logistic regression).Data analysis result indicated the existence of PM,o concentration related to temperature variable (p = 0,022), dampness (p = 0,002) and wind velocity (p = 0,006). While data analysis for the occurrence of non infection bronchi trouble with PM16 concentration variable (p = 0,001), age (p = 0,011), work time (p = 0,044) and smoking habit (p = 0,000). From all factors which related significantly, smoking habit is a dominant factor which affecting for the occurrence of non infection bronchi trouble. Therefore, factors which affected for occurrence of non infection bronchi trouble must be lessened, especially for smoking habit."

"Latar Belakang: Kanker paru merupakan salah satu kanker yang paling sering terjadidan menyebabkan angka kematian yang cukup tinggi. Salah satu komplikasi yang dapattimbul adalah infeksi oportunistik berupa mikosis paru. Mikosis paru masih jarangdikenali, padahal menyebabkan beban kesehatan dan peningkatan laju mortalitas. Salahsatu penyebabnya adalah diagnosis yang masih menjadi tantangan karena tidakspesifiknya gejala klinis dan uji diagnosis tidak invasif yang ada juga masih belumdiketahui kepastian tingkat akurasinya.Tujuan: Penelitian ini bertujuan untuk mengetahui kaitan berupa nilai akurasi hasildiagnosis immunodiffusion test (IDT) dibandingkan dengan profil IgG spesifikAspergillus.Metode: Metode penelitian ini adalah dengan uji laboratorium IDT dan IgG spesifikAspergillus dengan desain studi potong lintang. Pemeriksaan IDT menggunakan crudeantigen Aspergillus sedangkan pemeriksaan IgG spesifik Aspergillus menggunakan kitkomersial Dynamiker dengan hasil positif jika nilai absorbansi di atas 120 AU/mL.Hasil: Berdasarkan 70 subjek didapatkan karakteristik sebagai berikut yaitu subjekumumnya berjenis kelamin laki-laki 61,4% (n=43), berusia di atas 60 tahun 54,3%(n=38), memiliki riwayat merokok 60,0% (n=42) dengan indeks Brinkmann berat31,4% (n=22). Pasien umumnya memiliki jenis histologi berupa adenokarsinoma 74,3%(n=52) dengan stadium IIIB-IV sebesar 78,6% (n=55) dan tampilan status kategori PS 140,0% (n=28). Prevalensi aspergillosis berdasarkan IgG spesifik Aspergillus padapenelitian ini adalah 25,7%, sedangkan prevalensi jika menggunakan IDT sebesar 42,9%. Nilai akurasi IDT dengan IgG spesifik Aspergillus sebagai baku emas menunjukkan tingkat sensitivitas 44,4% (IK95% 21,5%-67,4%), spesifisitas 57,7% (IK95% 44,3%-71,1%), nilai duga positif 26,7% (IK95% 10,8%-42,5%), dan nilai duganegatif 75,0% (IK95% 61,6%-88,4%) dan nilai Kappa sebesar 0.017. Selain itu, terdapat hubungan yang bermakna secara statistik antara jenis kelamin dan indeks brinkmann terhadap hasil pemeriksaan IDT Aspergillus (p<0.05).Kesimpulan: IDT bukan merupakan metode diagnosis yang baik dan perlu adanya validasi terhadap crude antigen yang digunakan.

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Background: Lung cancer is one of the most common cancers and causes a high

mortality rate. One of the complications that can arise is an opportunistic infection in

the form of pulmonary mycosis. Pulmonary mycosis is rarely recognized, even though it

causes a health burden and an increased mortality rate. One of the causes is the method

of diagnosis which is still a challenge because the clinical symptoms are not specific

and the existing non-invasive diagnostic tests are not yet known for its exact level of

accuracy.

Aim: This study aims to determine the correlation in the form of accuracy value of the

immunodiffusion test (IDT) diagnostic results compared to the Aspergillus-specific IgG

profile.

Method: The method of this research was laboratory tests in forms of IDT and

Aspergillus-specific IgG with cross-sectional study design. IDT test used crude antigen

while Aspergillus-specific IgG test used a commercial Dynamiker Kit with a positive

result if the absorbance value above 120 AU/mL.

Results: Based on 70 subjects, the characteristics of the subjects are mainly male 61.4%

(n=42) with age over 60 years old 54.3% (n=43), had a history of smoking 60% (n=42)

with a severe Brinkmann index 31.4% (n=22). Subjects generally had a histological

type of adenocarcinoma 74.3% (n=52) with stage IIIB-IV 78.6% (n=55) and

performance status category PS1 40.0% (n=28). The prevalence of aspergillosis in this

study was 25.7% using Aspergillus-specific IgG, while the prevalence when using IDT

was 42.9%. The IDT accuracy value with Aspergillus-specific IgG as the gold standard

showed a sensitivity level of 0.444 (95%CI 0.215-0.674), a specificity of 0.577 (95% CI

0.443-0.711), a positive predictive value of 0.267 (95% CI 0.108-0.425), and a negative

predictive value of 0.750 (95% CI 0.616-0.884) and the Kappa value is 0.017. In

addition, there was a statistically significant relationship between gender and the

Brinkmann index on the results of the Aspergillus IDT examination (p <0.05).

Conclusion: IDT is not a good diagnostic method and it is still necessary to validate the

crude antigen used."