Laporan Penelitian (simulated clinical problem)

Kasus 1

Seorang wanita usia 30 tahun datang ke RS dengan keluhab demam selama 1

minggu.Dokter menduga pasien tersebut menderita demam typhoid.Dokter lalu
menganjurkan pemeriksaan Typhidot (Rapid Dot-EIA) di laboratorium dan
ternyata hasilnya positif.

Pertanyaan

1. Berapakah kemungkinan sensitivitas?

2. Berapakh kemungkinan spesivitas?
3. Berapakah kemungkinan PPV? Dari pasien yng menderita demam tifoid.

INITIAL APPRASIAL

Judul Jurnal/Artikel : A Systematic Evaluation of Rafid Dot-Eia,Blood Culture

and Widal Test in The Diagnosis Of Typhoid Fever
Penulis : Sanjeev H,Swetha Nayak,Pai Asha K.B,Vimal karnaker and Ganesh
H.R
Publikasi : Nitte University Journal of Health Science
Tahun : Maret 2013
Edisi : Jurnal Vol. 3, No.1, March 2013, ISSN 2249-7110
Co- Responden : Sanjeev H.
Kontributor : Department of Microbiology, K.S. Hegde Medical Academy, Nitte
University, Mangalore - 575 018, Karnataka, India
Website : http://nitte.edu.in/journal/March2013/ASEORD.pdf.

CONTENT ANNALYSIS
Cakupan :

Abstract :
Background : Typhoid fever, caused by Salmonella enterica serotype Typhi, is
endemic in the Indian sub-continent including Bangladesh,South-east and Far-east
Asia, Africa and South Central America. The disease can occur in all age group
with highest incidence among
children. Blood culture is regarded as the gold standard for diagnosis and carry
70-75% diagnostic yield in the first week of illness.However, this requires
laboratory equipment and technical training that are beyond the means of most
primary health care facilities in the developing world. Typhidot is a rapid dot-
enzyme immune assay (EIA), which detects IgG and IgM antibodies to a specific
50 kD outer membrane protein (OMP) antigen of Salmonella enterica serotype
Typhi. Typhidot becomes positive as early as in the first week of fever. The
results can be visually interpreted and is available within one hour.
Materials and method : Fifty blood samples, collected aseptically from patients
clinically diagnosed of Typhoid fever, were evaluated byblood culture, Widal test
and Typhidot.
Results : Of the 50 patients, 33 (66%) were positive by blood culture. Widal test
was positive in 33(66%) patients which included 26 in blood culture positive
patients and 7 in blood culture negative patients. Typhidot was positive in 37
(74%) patients. Thus, in comparison to the gold standard test i:e blood culture,
Typhidot and Widal test had sensitivity and specificity of 100% & 76% and
78.78% & 58.82%respectively.
Conclusion : Typhidot is found to have high sensitivity and good specificity and
could be applied as a good alternate in resource poornation. Further, it is simple to
perform, reliable when compared to Widal test, and rapid, with results being
available in one hour whencompared to 48 hours for blood culture and 18 hours
for Widal test.
Key words : Typhidot, Blood culture, Widal, Salmonella enterica
Subjek : The study was conducted in the Department of Microbiology, K.S.
Hegde Medical College and Hospital,located in Mangalore. Blood was collected
from 50 patients who were clinically diagnosed with typhoid fever.
Hasil peneitian :

/
 Untuk table 3

Sensitivitas = a / (a +c ) x 100%
= 30 /30 +7 x100%
= 81,081%
Spesifitas = d/(b+d) x 100%
= 10/(3+10)x100%
= 76,923%
PVV = a/(a+b)x100%
=30/(30+3)x100%
 =90,909%

Kesimpulan :
Typhidot adalah serodiagnostic baru, murah dan handal
tes yang tersedia secara komersial dan telah dilaporkan ke
9 memiliki sensitivitas yang baik dan spesifisitas. Dalam penelitian ini,
sensitivitas dan spesifisitas Typhidot adalah 100% dan
76,5% masing-masing.
Tes Widal telah digunakan selama lebih dari satu abad dalam
mengembangkan
negara untuk mendiagnosis demam tifoid tetapi telah
dilaporkan memiliki sensitivitas rendah, spesifisitas dan positif
9 nilai prediktif. Dalam penelitian ini, uji Widal adalah
positif dalam 66% (33/50) dari pasien. Tes Widal adalah
positif dalam 26 pasien positif budaya 33 darah dan 7
pasien negatif kultur darah. Sehingga tes harus
sensitivitas 78,78% dan spesifisitas 58,82%. Ini
5, 9, 15 menguatkan baik dengan data dari daerah endemis.

Dapat disimpulkan bahwa meskipun kultur darah masih merupakan

standar emas, Typhidot ditemukan memiliki sensitivitas tinggi
dan spesifisitas yang baik dan dapat diterapkan sebagai baik
alternatif di sumber daya negara miskin. Selanjutnya, itu adalah sederhana untuk
melakukan, handal jika dibandingkan dengan tes Widal dan cepat,
dengan hasil yang tersedia dalam satu jam bila dibandingkan dengan
48 jam untuk kultur darah dan 18 jam untuk tes Widal.