Perbedaan Gejala Klinis dan Gambaran Radiologis pada Tuberkulosis Paru Anak Berdasarkan Usia di RSUD Al Ihsan Tahun 2018

Muhammad Riki Hidayat, Tjoekra Roekmantara, Lisa Adhia Garina

Abstract


Abstract. Tuberculosis is one of the 10th highest infectious diseases causing death worldwide. according to the World Health Organization (WHO), in 2017 Indonesia became the third country to have the largest tuberculosis case worldwide with the incidence of pediatric pulmonary tuberculosis around 49,000 children. The age difference in a child's pulmonary tuberculosis can lead to different clinical and radiological manifestations caused by factors body's defense system development. This study uses an analytic observational design with a cross sectional approach to determine differences in clinical symptoms and radiological features in pulmonary tuberculosis based on age. The number of samples used was 260 children with a diagnosis of pulmonary tuberculosis. Data is taken from June to December 2019 at RSUD Al-Ihsan. Data were analyzed using the chi square method with a significance level of 95% (α = 0.05). The result found that child's pulmonary tuberculosis occurs predominantly in male child (54%), with an average age of 4.5 years and an average body weight is 14 kilograms. Based on the results of the study found a significant difference in clinical symptoms of cough (p <0.001) with mostly occur in children under the age of five years, while from radiological findings there is a significant difference of Hilar lymphadenopathy (p = 0.001) mostly occurs in children over five years.

Keywords: Children, clinical symptoms, Radiological, Tuberculosis

Abstrak. Tuberkulosis merupakan salah satu dari 10 penyakit menular penyebab kematian tertinggi  di dunia, menurut World Health Organization (WHO) pada tahun 2017 Indonesia menjadi negara ketiga yang memiliki kasus tuberkulosis terbesar di dunia dengan insidensi Tb paru anak sekitar 49.000 orang. Perbedaan umur pada Tb paru anak dapat menimbulkan manifestasi klinis dan radiologis berbeda disebabkan oleh faktor sistem pertahanan tubuh yang sedang berkembang, Penelitian ini menggunakan desain penelitian observasional analitik dengan pendekatan cross sectional untuk mengetahui perbedaan gejala klinis dan gambaran radiologis pada Tb paru berdasarkan usia. Jumlah sampel yang digunakan sebanyak 260 anak dengan diagnosis Tb paru. Data diambil dari bulan Juni hingga bulan Desember 2019 di RSUD Al-Ihsan. Data dianalisis menggunakan metode chi square dengan derajat kemaknaan 95% (α = 0,05).  Hasil penelitian ini ditemukan pada Tb paru anak rata-rata berjenis kelamin laki-laki (54%), dengan rata-rata usia 4,5 tahun serta rata-rata berat badan 14 kilogram. Berdasarkan hasil penelitian ditemukan perbedaan yang bermakna pada gejala klinis batuk (p<0,001) dengan jumlah lebih banyak pada anak usia dibawah lima tahun, sedangkan pada gambaran radiologis terdapat perbedaan yang bermakna pada gambaran hilar limfadenopati (p=0,001) dengan jumlah lebih banyak pada anak diatas lima tahun.

Kata Kunci: Anak, Gejala Klinis, Radiologis, Tuberkulosis


Keywords


Anak, Gejala Klinis, Radiologis, Tuberkulosis

Full Text:

PDF

References


WHO. Global tuberculosis report. 2018 Jul 3:7—25.

Kementerian Kesehatan Republik Indonesia. Tuberkulosis. InfoDATIN. 2018 May 16:1—5.

Putra IA. Profil Tuberkulosis Pada Anak di Instalasi Rawat Jalan RSUD . Raden Mattaher Jambi. 2013;51–60.

Mcmichael A, Simon AK, Hollander GA. Evolution of the immune system in humans from infancy to old age. Proc R Soc B, Biol Sci. 2015;282:1—9.

Kementerian Kesehatan Republik Indonesia Ditjen PP dan PL. Pedoman Nasional Pengendalian Tuberkulosis. Pedoman Nasional Pengendalian Tuberkulosis. 2014 November:38.

Rahajoe NN, Nawas A, Setyanto DB, Kaswandani N, Triasih R, Indawati W, et al. Buku petunjuk teknis manajemen dan tatalaksana Tb anak. Ministry of Health of the Republic of Indonesia. 2016:9—19.

Karim T, Sa Q, Ma R. Correlation between clinical and radiological presentation of pulmonary tuberculosis in children. 2013;42(1):12–5.

García-Basteiro AL, López-Varela E, Augusto OJ, et al. Radiological findings in young children investigated for tuberculosis in Mozambique. PLoS One. 2015;10(5):1–12.

A.T. C. Pediatric tuberculosis. Pediatr Rev . 2010;31(1):13–26.

Nayak S, Acharjya B. Mantoux test and its interpretation. Indian J Dermatol. 2012;57(1):3–8.

Iulia Ioan, Mathias P, Laurianne C, Jana P, dkk. What is chronic cough in children?. Frontiers in Physiology. 2014 August;5(332):1—5

Pramod S, Jean-Martin L. Infections and Diseases of the Lungs, Pleura,and Mediastinum. 2012;7(66):855-880.

Haridini Intan S. Mahdi, Darmawan B. Setyanto, Evita B.Ifran. Gambaran Klinis dan Radiologis pada Pasien dengan Uji Mantoux Positif di Bangsal Rawat Inap Anak RSUD Tangerang. 2008 Desember;10(4):250—254.

Soumya Swaminathan, Jotam G.P, Geetha R, D. Drug Concentration Thresholds Predictive of Therapy Failure and Death in Children With Tuberculosis: Bread Crumb Trails in Random Forests. 2016;63(3):64—73.

Anasta Putra, Amelia. Profil Tuberkulosis Pada Anak di Instalasi Rawat Jalan RSUD. Raden Mattaher Jambi. JMJ. 2013 May;1(1): 51-6

Amado C , Ferrer D, Agüero and Ocejo-Vinyals J. Clinical, Radiological and Inmunological Features in Children with Pulmonary Tuberculosis: A Review.Mycobacterial Disease:2014;4(4): 1-4.

Ashu Seith Bhalla, Ankur Goyal, Randeep Guleria1, Arun Kumar Gupta. Chest tuberculosis: Radiological review and imaging recommendations. Chest Radiology. 2015 August; 25(3):21




DOI: http://dx.doi.org/10.29313/kedokteran.v0i0.21193

Flag Counter