Tesis

Proporsi infeksi TB laten dengan menggunakan IGRA pada orang kontak serumah dengan pasien TB resistan obat di RSUP Persahabatan = Proportion of latent TB infections using IGRA in household contacts of drug-resistant TB patients at Persahabatan Hospital.

Latar belakang: Kontak erat dalam rumah tangga dengan penderita tuberkulosis yang resistan terhadap obat mempunyai risiko tinggi tertular tuberkulosis. Infeksi tuberkulosis laten adalah suatu keadaan tertular tuberkulosis tetapi tidak menunjukkan gejala. Tujuan penelitian ini adalah untuk mengetahui proporsi infeksi tuberkulosis laten pada masyarakat yang melakukan kontak serumah dengan penderita tuberkulosis resistan obat, mengetahui karakteristik orang yang tertular tuberkulosis laten, hubungan faktor risiko tuberkulosis laten dan hubungan total limfosit dengan IGRA. Metode: Subjek adalah mereka yang memenuhi kriteria inklusi dan eksklusi. Kriteria inklusi adalah subjek yang berusia lebih dari 18 tahun dan kriteria eksklusi adalah subjek yang tidak terdiagnosis tuberkulosis aktif, riwayat tuberkulosis dan imunokompromais. Penelitian ini merupakan penelitian deskriptif observasional dengan desain cross-sectional dengan periode pengambilan sampel dilakukan antara bulan April sampai dengan September 2022. Sampel darah diambil untuk pemeriksaan hitung limfosit total dan IGRA. Pemeriksaan foto toraks dilakukan untuk menyingkirkan bukti radiologis tuberkulosis aktif. Hasil: Sebanyak 85 subjek memenuhi kriteria inklusi dengan karakteristik jenis kelamin perempuan (67,1%), kelompok usia ≤ 60 tahun (92,9%) dengan rerata usia 44 tahun, tidak bekerja (41,2%), tidak merokok (72,9%), hasil foto toraks normal (84,7%) dan indeks massa tubuh normal (74,1%). Didapatkan proporsi pemeriksaan IGRA yaitu sebesar 57 (67,1%) subjek dengan menggunakan metode QIAreach QFT. Hasil analisis bivariat dan multivariat menunjukkan tidak terdapat perbedaan antara faktor-faktor seperti jenis kelamin, usia, gambaran foto toraks, indeks massa tubuh dan hitung limfosit total terhadap IGRA. Kesimpulan: Proporsi tinggi tuberkulosis laten dengan menggunakan IGRA pada orang yang kontak serumah dengan pasien TB resistan obat di RSUP Persahabatan. Tidak terdapat perbedaan bermakna secara statistik antara faktor-faktor yang memengaruhi terhadap IGRA.
Kata kunci: Interferon gamma relase assay, infeksi tuberkulosis laten, tuberkulosis resistan obat, kontak serumah


Background: Close household contact with drug-resistant tuberculosis patient has a high risk to be infected by tuberculosis. Latent tuberculosis infection is a condition where you are infected with tuberculosis but do not show symptoms. The aim of this study was to determine the proportion of latent tuberculosis infection in people who have household contact with drug-resistant tuberculosis sufferers; to determine the characteristics of people infected with latent tuberculosis; and the relationship between risk factors for latent tuberculosis and the relationship between total lymphocytes and IGRA. Method: Subjects were those who met the inclusion and exclusion criteria. The inclusion criteria were subjects aged more than 18 years and the exclusion criteria were subjects who were not diagnosed with active tuberculosis, had a history of tuberculosis, and were immunocompromised. This research is a descriptive observational study with a cross-sectional design. The subject collecting period is between April and September 2022. Blood samples were taken for the analysis of total lymphocyes and IGRA. Evaluation was performed with a chest x-ray to exclude radiological evidence for active tuberculosis. Results: A total of 85 subjects met the inclusion criteria with women (67.1%) predominantly. The age characteristics of the subjects showed an average age of 44 years with the majority of subjects being in the age group ≤ 60 years (92.9%). The other characteristics showed subjects who were not working (41.2%), do not smoking (72 .9%), normal chest x-ray results (84.7%), and have normal body mass index (74.1%). The proportion of IGRA examinations obtained was 57 (67.1%) subjects positive for ITBL using the QIAreach QFT method. The results of bivariate and multivariate analysis showed that there were no differences between risk factors such as gender, age, chest x-ray, body mass index and total lymphocytes count on IGRA. Conclusion: There is a high proportion of latent tuberculosis using IGRA in people who have household contact with drug-resistant TB patients at Persahabatan Hospital. There is no statistically significant differences between the factors influencing IGRA results.
Key words: Interferon gamma relase assay, latent tuberculosis infection, drug resistant tuberculosis, household contacts