Tesis

Sensitisasi Alergen pada Anak dengan Penyakit Alergi: Studi Potong Lintang di RSUP Sanglah Denpasar = Alergen Sensitization in Children with Allergy: A Cross-Sectional Study in Sanglah General Hospital Denpasar.

Latar belakang: Penyakit alergi didasari reaksi hipersensitivitas yang diinisiasi mekanisme imunologi spesifik diperantarai oleh IgE. Warga kota Denpasar memiliki karakteristik spesifik, yaitu tingkat memelihara hewan berbulu (anjing) dan konsumsi daging babi yang tinggi. Data sensitisasi alergen pada anak di kota Denpasar belum ada. Penelitian sensitisasi alergen dapat memberikan gambaran sensitisasi spesifik untuk anak di kota Denpasar sehingga upaya pencegahan penyakit alergi dapat dilakukan dengan lebih efektif. Tujuan: Mengetahui sensitisasi alergen pada anak dengan penyakit alergi (dermatitis atopi, asma, rinitis alergi) yang dibuktikan melalui uji tusuk kulit di RSUP Sanglah Denpasar. Metode: Penelitian potong lintang di Poliklinik Rawat Jalan Alergi Imunologi Bagian/SMF Ilmu Kesehatan Anak, RSUP Sanglah, Denpasar, periode Januari 2017-Maret 2017. Anak usia 3-18 tahun dengan dermatitis atopi, asma, rinitis alergi dan orang tua setuju mengikuti penelitian akan diinklusi. Sensitisasi alergen dibuktikan melalui uji tusuk kulit terhadap alergen spesifik (inhalan dan/atau ingestan), hasil positif bila diameter urtika 3 mm. Data dinyatakan sebagai proporsi, dilakukan pengelompokan berdasarkan jenis penyakit alergi dan umur. Hasil: Proporsi anak dengan penyakit alergi, yaitu dermatitis atopi 30,5%, asma 57,9%, dan rinitis alergi 56,8%. Proporsi berdasarkan multimorbiditas penyakit adalah dermatitis atopi dengan asma 8,5%, dermatitis atopi dengan rinitis alergi 4,2%, asma dengan rinitis alergi 24,2%, dermatitis atopi dengan asma dan rinitis alergi 4,2%, dermatitis atopi 13,7%, asma 21%, rinitis alergi 24,2%. Sensitisasi pada kelompok dermatitis atopi usia 3-6 tahun tersering terhadap alergen ingestan, usia sekolah baik pada dermatitis atopi, asma, maupun rinitis alergi sensitisasi terutama terhadap alergen inhalan (D. farinae, D. pteronyssinus, kecoa). Simpulan: Proporsi penyakit alergi tertinggi pada anak di kota Denpasar adalah asma dengan rinitis alergi. Sensitisasi terutama terhadap alergen inhalan pada anak usia sekolah.
Kata kunci: sensitisasi alergen, uji tusuk kulit, dermatitis atopi, asma, rinitis alergi, anak.


Background: Allergic disease in children is based on hypersensitivity reactions initiated by specific immunologic mechanism mediated by IgE. Residents of Denpasar city have their own characteristics in terms of the level of having furry animals (dogs) and the level of consumption of pork is high. While allergen sensitization data for the children of Denpasar is still not available. Allergen sensitization research in Denpasar will give a picture of the sensitization type specifically for children in Denpasar in order for having more effective prevention programs. Objectives: To study the sensitization of allergens in children with atopic dermatitis, asthma, and allergic rhinitis that proven through skin prick test at Sanglah Hospital Denpasar. Methods: A cross-sectional study was done in the Outpatient Immunology Allergy Polyclinic, Sanglah Hospital, Denpasar in the period of January to March 2017. Children 3-18 years who are diagnosed with atopic dermatitis, asthma, and allergic rhinitis, and the parents signed a letter of approval, will be included. Allergen sensitization proven by skin prick test against specific allergens (inhalants and/or ingestants), and it classified positive results when indicating wheal diameter ≥3 mm. The data is calculated as a proportion number and is grouped based on the type of allergy and age. Results: The proportion of children with allergy was atopic dermatitis 30.5%, asthma 57.9%, and allergic rhinitis 56.8%. While the proportion based on the multimorbidity of the disease is atopic dermatitis with asthma 8.5%, atopy dermatitis with allergic rhinitis 4.2%, asthma with allergic rhinitis 24.2%, atopy dermatitis with asthma and allergic rhinitis 4.2%, atopic dermatitis 13, 7%, asthma 21%, and allergic rhinitis 24.2%. Sensitization in the atopy dermatitis at age 3-6 years group frequently to ingestant allergen, but at school age in both atopic dermatitis, asthma, and allergic rhinitis sensitization especially to inhalants allergen (D. farinae, D. pteronyssinus, and cockroaches). Conclusions: Children in Denpasar showed the highest proportion of allergies for asthma and allergic rhinitis, with the majority of allergen are inhaled at school age.
Keywords: allergen sensitization, skin prick test, atopic dermatitis, asthma, allergic rhinitis, children