Pemeriksaan Urin untuk Menunjang Penegakan Diagnosis pada Pasien Tuberkulosis

Irma Nurul Hikmah Sitakar, Heni Muflihah, Achmad Mauludin

Abstract


Abstrack. Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis. Indonesia ranks the third largest TB case in the world in 2018. Diagnosis of TB still relies on microscopic examination of sputum which has a low accuracy value in detecting low bacterial counts, while culture takes a long time. In addition, high quality sputum is difficult to obtain due to disease conditions or in pediatric patients. Therefore, urine has the potential to be used in diagnostic methods because the collection of urine is easier than sputum and blood. The purpose of this study was to conduct a literature review to identify the potential for urine to support the diagnosis of TB. The method of searching for articles was done online from the Pubmed, Springer Link, and Science direc database. The steps for filtering the articles follow the PRISMA flow. In the final stage, 16 eligible articles were selected based on patient, intervention, comparison, outcome, and study (PICOS) criteria, namely TB patients, urine tests, TB diagnosis, and the original study.. The results showed that urine can be used to support the diagnosis of TB in 15 out of 16 articles. Urine lipoarabinomannan (LAM) and moleculare test MTB / RIF examinations can be used as a diagnostic alternative for TB patients, especially in HIV patients with suspected TB.

Keyword: Diagnosis, LAM, Tuberculosis,  Urine, Xpert MTB/RIF

Abstract. Tuberkulosis (TB) merupakan penyakit yang disebabkan Mycobacterium tuberculosis. Indonesia menempati urutan ketiga kasus TB terbanyak di dunia pada tahun 2018. Diagnosis TB masih bergantung pada pemeriksaan mikroskopik sputum yang memiliki nilai akurasi rendah dalam mendeteksi jumlah bakteri yang rendah, sedangkan kultur memerlukan waktu lama. Selain itu sputum yang berkualitas sulit didapat karena kondisi penyakitnya atau pada pasien anak. Oleh sebab itu, urin memiliki potensi untuk digunakan dalam metode diagnostik karena pengambilan urin yang lebih mudah dibandingkan sputum dan darah. Tujuan dari penelitian ini adalah melakukan literature review untuk mengidentifikasi potensi urin sebagai penunjang diagnosis TB. Metode pencarian artikel dilakukan secara online dari database Pubmed, Springer Link, dan Science direct. Tahapan penyaringan artikel mengikuti alur PRISMA. Pada tahap akhir, 16 artikel yang eligible dipilih berdasarkan kriteria patient,intervention, comparison, outcome, and study (PICOS), yaitu pasien TB, pemeriksaan urin, diagnosis TB, dan original study.  Hasil penelitian mendapatkan bahwa urin dapat digunakan untuk menunjang diagnosis TB pada 15 dari 16 artikel. Pemeriksaan deteksi liporaabinomannan (LAM) dan tes molekular MTB/RIF urin dapat digunakan sebagai alternatif diagnostik pasien TB terutama pada penderita HIV suspek TB.

Kata kunci: Diagnosis, LAM, Tuberkulosis, Urin, Xpert MTB/RIF


Keywords


Diagnosis, LAM, Tuberkulosis, Urin, Xpert MTB/RIF

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DOI: http://dx.doi.org/10.29313/kedokteran.v7i1.26817

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