Tesis

Proporsi Kasus Frambusia Berdasarkan Klinis dan Serologis pada Anak usia 1-12 Tahun di Desa Sei Berombang, Sumatera Utara Periode 22-27 Agustus 2016 = Yaws proportion based on clinical manifestation and serology in children age 1-12 years-old in Sei Berombang village, North Sumatera between 22nd - 27th of August 2016 periode.

Latar belakang: Frambusia atau yaws merupakan penyakit akibat infeksi Treponema pallidum subspecies pertenue yang menahun dan terutama mengenai kulit serta tulang. Penegakkan diagnosis berdasarkan klinis dan serologis. Program temuan kasus frambusia didasarkan atas temuan klinis menurut World Health Organization (WHO), kemungkinan terdapat frambusia tanpa lesi klinis yang tidak terdiagnosis masih belum dapat disingkirkan. Belum ada penelitian proporsi di suatu desa yang dinyatakan endemis. Tujuan: Mengetahui proporsi kasus frambusia berdasarkan kriteria klinis WHO dan pemeriksaan serologis di desa Sei Berombang pada anak usia 1-12 tahun periode 22-27 Agustus 2016. Metode: Studi potong lintang ini dilakukan pada tanggal 22-27 Agustus 2016 di desa Sei Berombang, Sumatera Utara. Pemilihan sampel dilakukan secara consecutive sampling. Subjek kemudian dilakukan anamnesis, pemeriksaan fisis, dan pemeriksaan rapid diagnostic test (RDT). Hasil : Didapatkan total 129 subjek dengan median usia 9 tahun (termuda 1 tahun dan tertua 12 tahun). Sebanyak 14 anak dengan lesi klinis suspek frambusia, sedangkan 4 anak dengan RDT yang positif. Hanya 3 anak dari RDT yang positif memiliki temuan klinis. Lesi klinis suspek frambusia yang paling banyak ditemukan adalah makula hipopigmentasi dan skar atrofik, sedangkan lokasi tersering adalah tungkai bawah. Simpulan: Ditemukan proporsi suspek frambusia berdasarkan klinis adalah 10,85%, sedangkan proporsi frambusia konfirmasi berdasarkan klinis dan serologis adalah 2,33%. Dua subjek didiagnosis frambusia laten, sedangkan satu subjek didiagnosis sebagai frambusia primer.
Kata kunci: frambusia, proporsi, anak


Background: Yaws is a chronic infectious disease caused by Treponema pallidum subspecies pertenue, mainly affecting skin and bone. Diagnosis of yaws is based on clinical manifestation and serologic test. According to WHO, yaws detection program is focused on clinical manifestation. Thus, it is possible that latent yaws without any clinical manifestation is still under-diagnosed. Until recently, there is no proportion study performed in remote endemic village. Objective: To determine the proportion of yaws based on WHO clinical criteria and serologic test in children age 1-12 years old in Sei Berombang village. Methods: This cross-sectional study was conducted on 22 nd -27 th August 2016 in Sei Berombang village, North Sumatra. We recruited the subjects consecutively and performed anamnesis, clinical examination, and rapid diagnostic test (RDT). Results: A total of 129 subjects were examined with median age of 9 years old (112 years old). Yaws was suspected in 14 subjects, but only 4 subjects were reactive to RDT. Three subjects had clinical manifestation and RDT reactive. Hypopigmentation patch and atrophic scar were the most common clinical findings in this study. Most lesions were found in lower extremities. Conclusion: Proportion of suspected yaws based on clinical manifestation is 10,85% in this study. Proportion of confirmed yaws based on clinical manifestation and serology is 2,33%. Two subjects diagnosed with latent yaws and one subject was diagnosed with primary yaws.
Keywords: yaws, proportion, children