Latar Belakang : Diagnosis tuberkulosis pada anak tidak mudah sehingga sering terjadi under diagnosis atau over diagnosis. Uji tuberkulin sebagai penunjang untuk mengetahui infeksi tuberkulosis memiliki angka negatif palsu 10-25%. Mayoritas pasien tuberkulosis anak memiliki kadar seng plasma yang rendah dibanding anak sehat. Tujuan : Mengetahui efektivitas krim seng topikal untuk meningkatkan diameter indurasi uji tuberkulin pada pasien TB anak. Metode : Uji klinis tidak tersamar dengan subjek penelitian bertindak sebagai perlakuan dan kontrol (matching) yang berlangsung selama bulan Oktober 2012 hingga Desember 2012. Subjek penelitian merupakan pasien tuberkulosis usia 2- 18 tahun di Departemen IKA RSCM dan Bagian Anak RS Persahabatan yang memenuhi kriteria inklusi dan eksklusi Analisis data penelitian dengan menggunakan uji non parametrik Wilcoxon signed rank test menggunakan SPSS versi 15. Hasil : Penelitian dilakukan pada 47 subjek. Mayoritas subjek penelitian memiliki status gizi baik (53%), median durasi pengobatan <6 bulan, median usia 72 bulan dan 47% merupakan kelompok usia <5 tahun. Sebanyak 16 subjek memiliki median selisih perbedaan indurasi uji tuberkulin lengan kanan dan kiri sebesar 1 mm (P<0,001) namun secara klinis tidak bermakna. Tiga puluh subjek lainnya tidak memiliki perbedaan indurasi uji tuberkulin lengan kanan dan kiri. Dua puluh subjek (43%) mengalami reaksi Koch setelah penambahan krim seng topikal. Pemberian krim plasebo tidak menyebabkan reaksi Koch. Simpulan : Pemberian krim seng topikal tidak terbukti bermakna secara klinis dalam meningkatkan indurasi uji tuberkulin dibandingkan krim plasebo.

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Background : Diagnosis of tuberculosis in children is difficult, under diagnosis or over diagnosis is commonly happened. Tuberculin test as an important supporting examination for tuberculosis infection has false negative value 10-25%. Majority of children with tuberculosis have lower plasma zinc level than healthy children.

Objective : To evaluate effectiveness of topical zinc cream in augmenting diameter of tuberculin induration among children with tuberculosis.

Methods : Unblinded clinical trial involving subjects matched with themselves was performed between October 2012 until December 2012. Subjects were children with tuberculosis aged 2-18 years old in Child Health Departement Cipto Mangunkusumo Hospital dan Persahabatan Hospital, Jakarta. Data analysis was performed with Wilcoxon signed rank test using SPSS 15 version.

Results : There were 47 subjects recruited in this study. Majority of subjects were well nourished (53%), underwent treatment <6 months (median), aged 72 months (median) and were under-five children (47%). Sixteen subjects showed 1 mm (median) difference of tuberculin induration between zinc arm and placebo arm (P<0,001). This difference is statistically significant but clinically insignificant. Twenty two subjects (43%) had Koch reaction after zinc cream application. Application of placebo cream didn't cause any Koch reaction.

Conclusion: Application of topical zinc cream is clinically insignificant to augment tuberculin induration compared to placebo cream.