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Perbandingan Hasil Deteksi Antibodi Spesifik Aspergillus Metode Immunochromatography Test (ICT) dengan Enzyme Linked Immunosorbent Assay (ELISA) pada Pasien TB Paru = Comparation between Aspergillus-specific antibody detection using Immunochromatography Test (ICT) and Enzyme Linked Immunosorbent Assay (ELISA) method in Pulmonary TB Patients.

Latar belakang: Indonesia memiliki beban tuberkulosis (TB) paru tinggi sehingga diperkirakan prevalensi koinfeksi mikosis paru juga tinggi, termasuk aspergilosis paru kronik (APK). Diagnosis APK masih menjadi tantangan di Indonesia karena keterbatasan sumber daya. Untuk diagnosis dini APK diperlukan alat diagnostik yang mudah, murah, dan memberikan hasil cepat dengan akurasi baik. Penelitian ini bertujuan untuk mengetahui nilai diagnostik ICT Aspergillus dibandingkan dengan ELISA 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 ELISA Aspergillus (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 47,16±17,1 tahun. Proporsi hasil positif ICT Aspergillus adalah 10,5% dan ELISA Aspergillus 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 dengan dugaan APK pada daerah dengan sumber daya terbatas.
Kata kunci: aspergillus, immunochromatography test (ICT), ELISA


Introduction: Indonesia has high pulmonary tuberculosis (TB) burden, so the estimation of pulmonary mycoses coinfection is also high, including chronic pulmonary aspergillosis (CPA). Diagnosis of CPA still becomes a challenge in Indonesia due to limited resources. A new rapid, user-friendly, inexpensive, and robust diagnostic tool is needed to assist CPA diagnosis. This study aims to evaluate the diagnostic value of the ICT Aspergillus compared to ELISA Aspergillus in pulmonary TB patients. Method: This cross-sectional study is part of previous study on CPA diagnostic of pulmonary TB patients in Jakarta. The sera of TB patients who met the inclusion criteria were tested using ICT Aspergillus (LDBio, Diagnostics, Lyon, France) and ELISA Aspergillus (Bordier affinity products, Crissier, Switzerland) in Mycology Laboratory of Parasitology Department FMUI in February-November 2021. Result: From 105 subjects included, the proportion of men was 58,1%, and the age mean was 47,16±17,1 years. The positive results proportion of ICT Aspergillus was 10,5%, and ELISA Aspergillus was 43,8%. 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: The ICT Aspergillus has not shown an excellent diagnostic capacity as screening tools. However, ICT Aspergillus could be used for diagnosing suspected CPA in TB patients with limited-resource settings.