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"Indonesia saat ini merupakan penyumbang terbesar kasus frambusia di Asia Tenggara. Untuk mendukung eliminasi frambusia di Indonesia dibutuhkan uji diagnosik yang dapat mendiagnosis frambusia secara cepat, mudah, akurat sehingga uji tersebut dapat dipakai sebagai bagian dari survei komunitas. Uji diagnostik yang ada saat ini membutuhkan pemeriksaan serologi rapid plasma reagin (RPR)/veneral disease research laboratory (VDRL) sehingga akan menimbulkan kesulitan karena mayoritas kasus frambusia ditemukan di daerah terpencil yang tidak memiliki fasilitas laboratorium lengkap. Penelitian ini bertujuan untuk menentukan nilai diagnostik dari rapid diagnostic test (RDT) Chembio Dual Path Platform® (DPP) Syphilis Screen and Confirm dalam mendiagnosis frambusia pada anak usia 2 - 15 tahun di Kabupaten Alor, Nusa Tenggara Timur. Pemeriksaan RDT DPPÒ, RPR, dan treponema pallidum haemagglutination assay (TPHA) dilakukan pada setiap subjek penelitian. Sebanyak 197 subjek berpartisipasi dalam penelitian ini. Nilai sensitivitas, spesifisitas, nilai duga positif, dan nilai duga negatif garis non-treponemal RDT DPPÒ adalah tidak dapat dinilai, 73.6% (IK 95% 66.87- 79.61), 0%, dan 100%. Nilai sensitivitas, spesifisitas, nilai duga positif, dan nilai duga negatif garis treponemal RDT DPPÒ adalah 0%, 94.7% (IK 95% 90.63-97.47), 0%, dan 97.3% (IK 95% 97.24-97.41). Proporsi kasus frambusia, baik kasus konfirmasi maupun laten, berdasarkan pemeriksaan RPR dan TPHA adalah 0%. Berdasarkan hasil penelitian ini, kemampuan RDT DPPÒ untuk diagnosis kasus frambusia tidak dapat disimpulkan karena tidak ditemukan kasus aktif frambusia.

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Indonesia is currently the largest contributor to yaws cases in Southeast Asia. To support yaws elimination in Indonesia, a diagnostic test that can diagnose yaws quick, easy, and accurate is needed so that the test can be used as part of a community survey. Current diagnostic tests require serologic rapid plasma reagin (RPR)/veneral disease research laboratory (VDRL) test, which will cause difficulties because the majority of yaws cases are found in remote areas that do not have complete laboratory facilities. This research aims to determine the diagnostic value of the rapid diagnostic test (RDT) Chembio Dual Path Platform® (DPP) Syphilis Screen and Confirm for diagnosing yaws in children aged 2 - 15 years in Alor, East Nusa Tenggara. RDT DPPÒ, RPR, and treponema pallidum haemagglutination assay (TPHA) test were performed on each subject. Total of 197 subjects participated in this study. The sensitivity, specificity, positive predictive value, and negative predictive value of the non-treponemal RDT DPPÒ line were unassessable, 73,6% (95% CI 66,87-79,61), 0%, and 100%. The sensitivity, specificity, positive predictive value, and negative predictive value of the treponemal RDT DPPÒ line were 0%, 94,7% (95% CI 90,63-97,47), 0%, and 97,3% (95% CI 97,24-97,41). The proportion of confirmed cases of yaws based on RPR and TPHA test was 0%. Based on the results of this study, the ability of RDT DPPÒ for the diagnosis of yaws cases cannot be concluded because there was no active yaws cases were found."

"Latar belakang: Eradikasi frambusia tahun 2020 belum tercapai. Penilaian klinis mengacu pada pedoman WHO. Beberapa studi terakhir melaporkan perkembangan gambaran klinis frambusia menjadi tidak khas, dengan skar yang dilaporkan sebagai temuan terbanyak. Lesi yang tidak dikenali menyebabkan konfirmasi serologi akan terlewat. Saat ini skar sudah dicantumkan kembali ke dalam pedoman WHO terkini, namun belum termasuk dalam katerogi lesi kasus suspek berdasarkan Peraturan Menteri Kesehatan (Permenkes) nomor 8 tahun 2017. Diagnosis frambusia diawali dengan penilaian kasus suspek atau probable, dikonfirmasi dengan pemeriksaan rapid diagnostic test dan pemeriksaan rapid plasma reagin jika meragukan. Alat uji baru RDT DPP telah dianjurkan WHO untuk daerah endemis tanpa fasilitas laboratorium lengkap serta dikombinasikan penggunaannya dengan RDT Biosensor. Tujuan: Menilai kesesuaian gambaran klinis frambusia berdasarkan pedoman WHO terhadap RDT STANDARD Q Syphilis AB Biosensor dan RDT CHEMBIO Dual Path Platform (DPP) Syphilis Screen and Confirm dalam mendiagnosis frambusia pada anak usia 2─15 tahun di Kabupaten Alor, Nusa Tenggara Timur. Metode: Setiap satu sampel penelitian dinilai gambaran klinis dugaan frambusia berdasarkan pedoman WHO, diperiksakan RDT Biosensor, serta RDT DPP. Hasil pemeriksaan akan dinilai kesesuaiannya. Hasil: Terdapat 197 subjek penelitian yang diikutsertakan dalam penelitian ini. Lesi kulit terbanyak yaitu skar frambusia (79,7%). Proporsi kesesuaian keseluruhan gambaran klinis terhadap RDT Biosensor yaitu 28,9% (p=1,000) dan terhadap RDT DPP yaitu 26,9% (p=0,202). Kesesuaian antara gambaran klinis suspek frambusia terhadap hasil RDT Biosensor positif sebesar 77,3% dan terhadap hasil RDT DPP positif sebesar 100%. Selain itu terdapat kesesuaian sebesar 22,8% antara gambaran klinis bukan frambusia dengan RDT Biosensor negatif dan 23,8% dengan RDT DPP negatif. Kesimpulan: Kesesuaian antara gambaran klinis dugaan frambusia berdasarkan pedoman WHO terhadap RDT bernilai rendah, sehingga gambaran klinis kurang dapat dijadikan acuan awal dalam menegakkan diagnosis frambusia di daerah endemis.

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Background: Yaws eradication in 2020 has not been achieved. Clinical assessment refers to WHO guidelines. Several recent studies reported the development of the atypical yaws clinical features, scar was reported as the most common finding. Unrecognized lesions cause serological confirmation to be missed. Currently, scar is not included in the suspected cases category based on the Regulation of the Minister of Health (Permenkes) number 8 of 2017. Yaws diagnoses begins with the assessment of suspected or probable cases, confirmed by a rapid diagnostic test and rapid plasma reagin examination if in doubt. The new RDT DPP test kit has been recommended by WHO for endemic areas without complete laboratory facilities and its combined use with the RDT Biosensor. Objective : Assessing the suitability of the clinical features of yaws based on WHO guidelines with the STANDARD Q Syphilis AB Biosensor and CHEMBIO Dual Path Platform (DPP) Syphilis Screen and Confirm in diagnosing yaws in children aged 2-15 years in Alor District, East Nusa Tenggara. Methods: Each study sample was assessed for suspected yaws clinical features based on WHO guidelines, examined for RDT Biosensor, and RDT DPP. Results : There were 197 research subjects who were included in this study. Scar was the clinical feature that mostly found (79,7%). Overall percent agreement between clinical features with the RDT Biosensor was 28.9% (p=1,000) and against the RDT DPP was 26.9% (p=0,202). The concordance between yaws clinical features between the positive RDT Biosensor result was 77.3% and the positive RDT DPP result was 100%. In addition, there is a 22.8% concordance between the clinical features of non yaws with a negative Biosensor RDT and 23.8% with a negative RDT DPP.Conclusion : The concordance between yaws clinical features based on WHO guidelines for RDT is low, so that the clinical features should not be used as an initial reference in establishing a diagnosis of yaws in endemic areas."