Scoping Review: Rasio Monosit Limfosit sebagai Penunjang untuk Menegakkan Diagnosis pada Pasien Tuberkulosis

Algifari Fauzia, Purwitasari Purwitasari, Heni Muflihah


Abstract. Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis. Indonesia is the third largest TB burdened country in the world. Bacteriological examination is the standard for diagnosing TB. Bacterial culture examination has limitation for its prolonged time, whereas rapid molecular assay is unable to detect viable bacteria. Interferon- γ release assays (IGRA) examination are expensive and require special equipment. Hematology examination is common and has potential to support TB diagnosis based on immunological parameters. The purpose of this study was to conduct a literature review to identify the potential for monocyte lymphocyte ratio (MLR) to support the diagnosis of TB. Search for articles was conducted online from Pubmed, Springer Link, and Science Direct databases. The steps of filtering articles are follow the PRISMA flow. In the final stage, eligible articles were selected based on patient, intervention, comparison, outcome, and study (PICOS) criteria, that is TB patient, monocyte lymphocyte ratio, TB diagnosis, and the original study. The results of this study obtained seven articles from 8.942 articles found from keywords. Two of the seven articles said that MLR could support the diagnosis of TB. Two articles showed that monocytes and lymphocytes could be markers of bacterial infection including TB. One article said the association of TB with decreased production of monocyte and lymphocyte cytokines. Two articles said that MLR had no relationship with TB cases. There is one article stats the MLR value limit is 0.378 to support the diagnosis of TB. Observational research on MLR to support the diagnosis of TB in Indonesia still needs to be done, especially the assessment of the limit of the MLR value.

Keywords: Diagnosis, Hematology, Lymphocyte, Monocyte, Tuberculosis

Abstrak. Tuberkulosis (TB) merupakan penyakit yang disebabkan Mycobacterium tuberculosis. Indonesia menempati urutan ketiga kasus TB terbanyak di dunia. Pemeriksaan bakteriologis menjadi standar untuk menegakkan diagnosis tuberkulosis. Keterbatasan pemeriksaan kultur bakteri adalah membutuhkan waktu yang lama sedangkan pemeriksaan TCM tidak selalu menunjukkan bakteri masih hidup. Pemeriksaan imunologis interferon- γ release assays (IGRA) memiliki harga mahal dan membutuhkan alat khusus. Pemeriksaan hematologi rutin mudah dilakukan, sehingga memiliki potensi menunjang penegakkan diagnosis TB berdasarkan parameter imunologis. Tujuan dari penelitian ini adalah melakukan literature review untuk mengidentifikasi potensi rasio monosit limfosit (MLR) sebagai penunjang diagnosis TB. Pencarian artikel dilakukan secara online dari database Pubmed, Springer Link, dan Science direct. Tahapan penyaringan artikel mengikuti alur PRISMA. Pada tahap akhir, artikel yang eligible dipilih berdasarkan kriteria patient, intervention, comparison, outcome, and study (PICOS), yaitu pasien TB, rasio monosit limfosit, diagnosis TB, dan original study. Hasil penelitian ini mendapatkan tujuh artikel dari jumlah awal 8.942 artikel yang ditemukan dari kata kunci. Dua dari tujuh artikel menyatakan MLR dapat menunjang diagnosis TB. Dua artikel menunjukkan monosit dan limfosit dapat menjadi penanda infeksi bakteri termasuk TB. Satu artikel menyatakan hubungan TB dengan penurunan produksi sitokin monosit dan limfosit. Dua artikel menyebutkan MLR tidak ada hubungan dengan kasus TB. Terdapat satu artikel yang menyebutkan batas nilai MLR 0,378 untuk menunjang diagnosis TB. Penelitian observasional tentang MLR untuk menunjang diagnosis TB di Indonesia masih perlu dilakukan terutama pengkajian batas nilai MLR.

Kata kunci: Diagnosis, Hematologi, Limfosit, Monosit, Tuberkulosis


Diagnosis, Hematologi, Limfosit, Monosit, Tuberkulosis


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