PENDEKATAN DIAGNOSIS TUBERKULOSIS PADA ANAK DI SARANA PELAYANAN KESEHATAN DENGAN FASILITAS TERBATAS

Bakhtiar Bakhtiar

Abstract


Abstrak.  Tuberkulosis pada anak masih merupakan penyakit dengan tingkat morbiditas dan mortalitas yang tinggi.  Hal ini diperkirakan berkaitan dengan kesulitan dalam menegakkan diagnosis, terutama diagnosis pasti, yaitu ditemukannya M. Tuberculosis dari spesimen penderita. Kemajuan teknologi diagnostik memang telah berkembang pesat, namum  hanya bisa dilakukan di pusat pelayanan kesehatan yang  lengkap. Untuk mengatasi  permasalahan ini, terutama di sarana pelayanan kesehatan dengan fasilitas  terbatas, dapat diterapkan suatu sistem  skoring. Dalam penerapannya, sistem skoring ini terdiri dari 8 parameter, yaitu: adanya kontak dengan penderita TB dewasa, uji tuberkulin, keadaan gizi, demam ≥ 2 minggu, batuk lebih dari 3 minggu, pembesaran kelenjar linfe, pembengkakan tulang/sendi, dan foto toraks. Nilai skor masing-masing berkisar 0-3. Dengan sistem skoring ini, diagnois TB pada anak ditegakkan bila jumlah skor ≥ 6.  Sistim skoring merupakan pendekatan diagnosis TB pada anak secara umum. Untuk diagnosis spesifik berdasarkan organ yang terlibat dibutuhkan analisis gambaran klinis yang spesifik dari organ tersebut dan pemeriksaan penunjang yang spesifik (JKS 2016; 2: 122-128)

Kata Kunci: Tuberkulosis, sistem skoring, pendekatan diagnosis.

Abstract. Tuberculosis in children is still a disease with high morbidity and mortality rate.  It is estimated that relates to the difficulty in establishing the diagnosis, especially a definite diagnosis, namely the discovery of M. tuberculosis from the patient specimen. Advances in technology diagnostic indeed been growing rapidly, but can only be done at the center complete health. To solve this problem, especially for services in health facilities with limited facilities, can be applied to a scoring system. In practice, the system of scoring is comprised of eight parameters: their contact with adult patients, tuberculin test, nutritional state, fever more than two weeks, the cough of more than three weeks, enlarged lymph nodes, swelling of bones and joints, and chest x-ray. The score of the eight parameters ranging from 0-3. With this scoring system, the diagnosis of TB in children is established when the total score is more than 6. Scoring System is an approach to diagnosing TB in children generally. For specific diagnosis based on the organs involved in the analysis required specific clinical features of these organs and specific investigations.

(JKS 2016; 2: 122-128)

Keywords: Tuberculosis, scoring system , diagnosis approach.


Keywords


Tuberkulosis, sistem skoring, pendekatan diagnosis. Tuberculosis, scoring system , diagnosis approach.

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References


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