Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: Kanker paru merupakan salah satu kanker yang paling sering terjadidan menyebabkan angka kematian yang cukup tinggi. Salah satu komplikasi yang dapattimbul adalah infeksi oportunistik berupa mikosis paru. Mikosis paru masih jarangdikenali, padahal menyebabkan beban kesehatan dan peningkatan laju mortalitas. Salahsatu penyebabnya adalah diagnosis yang masih menjadi tantangan karena tidakspesifiknya gejala klinis dan uji diagnosis tidak invasif yang ada juga masih belumdiketahui kepastian tingkat akurasinya.Tujuan: Penelitian ini bertujuan untuk mengetahui kaitan berupa nilai akurasi hasildiagnosis immunodiffusion test (IDT) dibandingkan dengan profil IgG spesifikAspergillus.Metode: Metode penelitian ini adalah dengan uji laboratorium IDT dan IgG spesifikAspergillus dengan desain studi potong lintang. Pemeriksaan IDT menggunakan crudeantigen Aspergillus sedangkan pemeriksaan IgG spesifik Aspergillus menggunakan kitkomersial Dynamiker dengan hasil positif jika nilai absorbansi di atas 120 AU/mL.Hasil: Berdasarkan 70 subjek didapatkan karakteristik sebagai berikut yaitu subjekumumnya berjenis kelamin laki-laki 61,4% (n=43), berusia di atas 60 tahun 54,3%(n=38), memiliki riwayat merokok 60,0% (n=42) dengan indeks Brinkmann berat31,4% (n=22). Pasien umumnya memiliki jenis histologi berupa adenokarsinoma 74,3%(n=52) dengan stadium IIIB-IV sebesar 78,6% (n=55) dan tampilan status kategori PS 140,0% (n=28). Prevalensi aspergillosis berdasarkan IgG spesifik Aspergillus padapenelitian ini adalah 25,7%, sedangkan prevalensi jika menggunakan IDT sebesar 42,9%. Nilai akurasi IDT dengan IgG spesifik Aspergillus sebagai baku emas menunjukkan tingkat sensitivitas 44,4% (IK95% 21,5%-67,4%), spesifisitas 57,7% (IK95% 44,3%-71,1%), nilai duga positif 26,7% (IK95% 10,8%-42,5%), dan nilai duganegatif 75,0% (IK95% 61,6%-88,4%) dan nilai Kappa sebesar 0.017. Selain itu, terdapat hubungan yang bermakna secara statistik antara jenis kelamin dan indeks brinkmann terhadap hasil pemeriksaan IDT Aspergillus (p<0.05).Kesimpulan: IDT bukan merupakan metode diagnosis yang baik dan perlu adanya validasi terhadap crude antigen yang digunakan.

---

Background: Lung cancer is one of the most common cancers and causes a high

mortality rate. One of the complications that can arise is an opportunistic infection in

the form of pulmonary mycosis. Pulmonary mycosis is rarely recognized, even though it

causes a health burden and an increased mortality rate. One of the causes is the method

of diagnosis which is still a challenge because the clinical symptoms are not specific

and the existing non-invasive diagnostic tests are not yet known for its exact level of

accuracy.

Aim: This study aims to determine the correlation in the form of accuracy value of the

immunodiffusion test (IDT) diagnostic results compared to the Aspergillus-specific IgG

profile.

Method: The method of this research was laboratory tests in forms of IDT and

Aspergillus-specific IgG with cross-sectional study design. IDT test used crude antigen

while Aspergillus-specific IgG test used a commercial Dynamiker Kit with a positive

result if the absorbance value above 120 AU/mL.

Results: Based on 70 subjects, the characteristics of the subjects are mainly male 61.4%

(n=42) with age over 60 years old 54.3% (n=43), had a history of smoking 60% (n=42)

with a severe Brinkmann index 31.4% (n=22). Subjects generally had a histological

type of adenocarcinoma 74.3% (n=52) with stage IIIB-IV 78.6% (n=55) and

performance status category PS1 40.0% (n=28). The prevalence of aspergillosis in this

study was 25.7% using Aspergillus-specific IgG, while the prevalence when using IDT

was 42.9%. The IDT accuracy value with Aspergillus-specific IgG as the gold standard

showed a sensitivity level of 0.444 (95%CI 0.215-0.674), a specificity of 0.577 (95% CI

0.443-0.711), a positive predictive value of 0.267 (95% CI 0.108-0.425), and a negative

predictive value of 0.750 (95% CI 0.616-0.884) and the Kappa value is 0.017. In

addition, there was a statistically significant relationship between gender and the

Brinkmann index on the results of the Aspergillus IDT examination (p <0.05).

Conclusion: IDT is not a good diagnostic method and it is still necessary to validate the

crude antigen used."

"Kanker paru sebagai salah satu kanker terbanyak di dunia merupakan faktor risiko dari infeksi oportunistik, seperti mikosis paru. Mikosis paru masih jarang dikenali akibat diagnosis yang masih menjadi tantangan karena gejala dan radiologis yang tidak spesifik dan uji diagnosis yang tidak invasif masih belum diketahui kepastian tingkat akurasinya. Studi ini dilakukan untuk mengetahui nilai akurasi hasil pemeriksaan immunodiffusion test (IDT) yang menggunakan crude antigen dibandingkan dengan profil immunoglobulin G (IgG) spesifik Aspergillus sebagai baku emas yang menggunakan kit Dynamiker dengan hasil positif jika absorbansi di atas 120 AU/mL. Penelitian dilakukan melalui uji laboratorium dengan desain studi potong lintang. Prevalensi aspergillosis berdasarkan IgG spesifik Aspergillus didapatkan 25,7% dan nilai akurasi IDT didapatkan sensitivitas 44,4% (IK95% 21,5%-67,4%), spesifisitas 57,7% (IK95% 44,3%-71,1%), nilai duga positif 26,7% (IK95% 10,8%-42,5%), dan nilai duga negatif 75,0% (IK95% 61,6%-88,4%) dengan nilai Kappa sebesar 0.017. Selain itu, terdapat perbedaan yang bermakna secara statistik antara jenis kelamin dan indeks Brinkmann terhadap hasil pemeriksaan IDT Aspergillus (p<0,05). Oleh karena itu, IDT bukan merupakan metode diagnosis yang baik dan perlu adanya perbaikan terhadap antigen yang digunakan.

---

Lung cancer as one of the most common cancers in the world is a risk factor for opportunistic infections, such as pulmonary mycoses. Pulmonary mycoses is still rarely recognized due to the challenging diagnosis because the symptoms and radiology are not specific and the accuracy value of diagnostic tests that are not invasive is still not yet known. This study was conducted to determine the accuracy of immunodiffusion test (IDT) using crude antigen compared to the Aspergillus-specific immunoglobulin G (IgG) as the gold standard using Dynamiker kit with the positive result if the absorbance value is above 120 AU/mL. The method of this research is laboratory test with a cross-sectional study design. The prevalence of aspergillosis based on Aspergillus-specific IgG is 25.7% and the accuracy values of IDT are sensitivity 44.4% (95% CI 21.5%-67.4%), specificity 57.7% (95% CI 44.3%-71.1%), positive predictive value 26.7% (95% CI 10.8%-42.5%), and negative predictive value 75.0% (95% CI 61.6%-88.4%) with Kappa value 0.017. Besides, there was a statistically significant difference between gender and the Brinkmann Index on the results of IDT examination (p>0.05). Therefore, IDT is not a good or reliable diagnostic method and there is a need for improvement or correction of the antigen used."

"Latar belakang: Tuberkulosis paru (TB) merupakan salah satu faktor risiko terjadinya aspergillosis paru kronik (APK). Keduanya sulit dibedakan karena gejala APK tidak spesifik dan mirip dengan TB. Diagnosis APK ditegakkan berdasarkan gejala klinis, pemeriksaan pencitraan dan laboratorium mikologi. Pemeriksaan serologi dengan metode presipitasi atau Immunodiffusion test (IDT) sudah dikembangkan sejak lama, murah dan mudah dilakukan, tetapi dianggap kurang akurat. Pemeriksaan deteksi antibodi immunoglobulin G (IgG) spesifik Aspergillus dengan metode enzyme-linked immunosorbent assay (ELISA) merupakan salah satu metode diagnosis APK. Metode ini cukup mahal dan belum dilakukan rutin di daerah dengan sumber daya terbatas. Tujuan: Penelitian ini bertujuan untuk mengetahui perbandingan hasil pemeriksaan IDT Aspergillus dengan pemeriksaan IgG spesifik Aspergillus pada pasien bekas TB di RSUP Persahabatan. Metode: Penelitian dengan desain uji diagnostik ini dilakukan sejak April 2019 - November 2020 dengan metode consecutive sampling. Pasien yang direkrut merupakan pasien bekas TB dari RSUP Persahabatan Jakarta. Pemeriksaan IDT dan IgG spesifik Aspergillus dilakukan di Laboratorium Departemen Parasitologi FKUI.Hasil: Dari 80 pasien bekas TB di RSUP Persahabatan sesuai kriteria inkulsi, sebanyak 57 pasien laki-laki (71,3%) dan 23 pasien perempuan (28,7%). Rerata usia pasien adalah 50,98±2,79 tahun, median indeks massa tubuh pasien sebesar (IMT) 18,37. Proporsi hasil pemeriksaan IDT pada pasien bekas TB adalah 36,25%, sedangkan IgG spesifik Aspergillus metode ELISA sebesar 48,75%. Nilai akurasi diagnostik IDT dibandingkan terhadap IgG spesifik Aspergillus metode ELISA menunjukkan sensitivitas 30,77%, spesifisitas 58,54%, nilai prediktif positif 41,38%, nilai prediktif negatif 47,06% dan nilai measurement of agreement dengan cohen’s kappa sebesar -0,108.Simpulan: Metode IDT memiliki akurasi lebih rendah dibandingkan IgG spesifik Aspergillus metode ELISA, sehingga penggunaan IgG spesifik Aspergillus lebih direkomendasikan. Teknik IDT dapat digunakan jika sumber daya terbatas, namun perlu dilakukan standarisasi antigen untuk pemeriksaan tersebut.

---

Background: Lung Tuberculosis (LTB) is a risk factor of developing chronic pulmonary aspergillosis (CPA). Both diseases are still difficult to differentiate because clinical presentation of CPA is not specific and similar to LTB. Diagnosis of CPA is confirmed by clinical presentation, radiographic examination and mycology laboratory tests. Serological testing using the precipitation method or immunodiffusion test (IDT) has long been conducted. It is a cheap and easy-to-do method, however the accuracy is not satisfied. Detection of the Aspergillus specific immunogobulin G (IgG) using enzyme-linked immunosorbent assay (ELISA) is one of the keys in diagnosing CPA. However, this method is more expensive and has not been conducted routinely in areas with limited resources.

Aim: This study aimed to determine the results of IDT Aspergillus compare to Aspergillus-specific IgG with ELISA in previous TB patients at Persahabatan Hospital.

Method: This diagnostic study was conducted from April 2019 - November 2020 and recruitment was performed by consecutive sampling. Patients recruited were previous TB patients from Persahabatan General Hospital; while IDT and specific Aspegillus IgG tests were conducted at Laboratory of Parasitology Dept, FMUI.

Conclusion: From 80 previous TB patients from the Persahabatan Hospital that met the inclusion criteria, 57 patients were male (71,3%) and 23 were female (28,7). Mean age was 50,98±2,79 years, median of patients body mass index (BMI) was 18,37. The proportion of old TB patients with positive IDT results was 36,25% and patients with positive IgG results was 48,75%. The diagnostic accuracy of IDT compared to IgG ELISA was 30,77% sensitivity, 58,54% spesificity, 41,38% positive predictive value, 47,06% negative predictive value and the measurement of agreement using cohen’s kappa was -0,108.

Summary: IDT Aspergillus is less accurate compared to Aspergillus-specific IgG ELISA. Therefore the use of Aspergillus-specific IgG ELISA is recommended as a serological test. The IDT method can be used at limited resources facilities, but it is necessary to standardize the antigen for the test."

"Latar belakang: Pasien kanker paru lebih rentan mengalami infeksi, termasuk infeksi jamur paru (mikosis paru) yang dapat memperburuk prognosis pasien. Aspergillus merupakan jamur penyebab mikosis paru yang paling sering, termasuk aspergilosis paru kronik (APK). Deteksi IgG spesifik Aspergillus berbasis enzyme-linked immunosorbent assay (ELISA) sering digunakan untuk diagnosis APK, tetapi penggunaannya masih terbatas karena berbagai kendala. Uji diagnosis APK dengan metode sederhana tetapi dengan hasil akurat diharapkan dapat mengatasi kendala tersebut, sekaligus meningkatkan kualitas tata laksana. Tujuan: Penelitian ini bertujuan untuk mengetahui hasil pemeriksaan ICT LD Bio Aspergillus dibandingkan dengan IgG-spesifik Aspergillus Dynamiker pada pasien kanker paru bukan sel kecil (KPKBSK) di RSUP Persahabatan. Metode: Penelitian ini merupakan uji diagnostik untuk membandingkan dua metode pemeriksaan APK yang lebih akurat. Rangkaian penelitian dilaksanakan sejak April 2019–Oktober 2020. Subjek penelitian adalah pasien KPKBSK di RSUP Persahabatan yang memenuhi kriteria inklusi. Pemeriksaan IgG spesifik Aspergillus Dynamiker dan ICT LD Bio Aspergillus dilakukan di laboratorium Departemen Parasitologi FKUI. Analisis statistik hasil perbandingan kedua metode tersebut dilakukan untuk mengetahui proporsi, sensitivitas, spesisifisitas, nilai duga positif & nilai duga negatif. Hasil: Dari 77 pasien yang memenuhi kriteria inklusi, proporsi hasil positif ICT LD Bio Aspergillus 14,3%, sedangkan IgG spesifik Aspergillus Dynamiker 22,1%. Sensitivitas ICT LD Bio Aspergillus dibandingkan dengan IgG spesifik Aspergillus Dynamiker 23,5%, sedangkan spesifisitasnya 88,3%. Nilai duga positif ICT LD Bio Aspergillus dibandingkan dengan IgG spesifik Aspergillus Dynamiker adalah 36,4%; sedangkan nilai duga negatifnya 80,3%. Kesimpulan: Hasil pemeriksaan ICT LD Bio ICT Aspergillus lebih baik dibandingkan dengan IgG spesifik Aspergillus pada pasien KPKBSK di RSUP Persahabatan.

---

Background: Lung cancer patients are more susceptible to infections, including pulmonary mycosis, which can worsen the prognosis. Aspergillus is the most common cause of pulmonary mycosis, including chronic pulmonary aspergillosis (CPA). Detection of Aspergillus-specific IgG with enzyme-linked immunosorbent assay (ELISA) is often used for diagnosis of CPA, but it is still a challenge. The CPA diagnosis with a simple method and accurate results is needed to improve the quality of patient’s management.

Aims: The study aimed to determine the results of ICT LD Bio Aspergillus compared with Aspergillus-specific IgG Dynamiker's in NSCLC patients at Persahabatan General Hospital.

Methods: This study is a diagnostic test to compare the ICT LD Bio Aspergillus with Aspergillus-specific IgG Dynamiker's which is more accurate for CPA diagnosis. The study was conducted from April 2019 to October 2020. The subjects were NSCLC patients at Persahabatan General Hospital who met the inclusion criteria. The serology tests were carried out at the laboratory of Parasitology Department, FKUI. The statistical analysis was performed to determine the proportion, sensitivity, specificity, positive and negative predictive values of the two tests.

Results: Of the 77 patients who met the inclusion criteria, the proportion of positive results for ICT LD Bio Aspergillus was 14.3%, while for Aspergillus-specific IgG Dynamiker's was 22.1%. The sensitivity of ICT LD Bio Aspergillus compared to Aspergillus-specific IgG Dynamiker was 23.5%, while the specificity was 88.3%. The positive predictive value of ICT LD Bio Aspergillus compared to Aspergillus-specific IgG Dynamiker was 36.4%; while the negative predictive value was 80.3%.

Conclusion: The ICT LD Bio Aspergillus is more accurate than Aspergillus-specific IgG in NSCLC patients at Persahabatan General Hospital."

"Latar Belakang : Pasien kanker paru rentan terhadap infeksi jamur. Candida dan Aspergillus merupakan jenis jamur paling banyak yang menyebabkan infeksi jamur pada pasien kanker. Penelitian ini bertujuan untuk mengetahui profil klinis, spektrum jamur dan imunoglobulin G spesifik Aspergillus pada pasien kanker paru yang belum dikemoterapi di RSUP Persahabatan.Metode : Penelitian ini berdesain potong lintang. Subjek penelitian adalah pasien KPKBSK yang sudah tegak jenis dan belum dikemoterapi yang berobat di RSUP Persahabatan. Dahak dan serum diperiksakan biakan jamur dan IgG spesifik Aspergillus di Departemen Parasitologi Fakultas Kedokteran Universitas Indonesia. Hasil biakan jamur dan IgG spesifif Aspergillus dianalisis untuk mengetahui hubungannya dengan demografi.Hasil : Subjek penelitian sebanyak 77 pasien. Hasil biakan dahak yang tumbuh jamur sebanyak 76 subjek (98,7%). Jumlah isolat jamur yang tumbuh ≥ dua spesies sebanyak 35 pasien (45,5%). Isolat jamur yang paling banyak tumbuh adalah Candida albicans (72,3%) dan Aspergillus niger (33,8%). Hasil IgG spesifik Aspergillus pada subjek penelitian yang positif sebanyak 22,1%. Terdapat hubungan bermakna antara umur dan leukosit dengan IgG spesifik Aspergillus dan antara umur dan jenis kelamin dengan biakan Aspergillus.Kesimpulan : Isolat jamur yang ditemukan di antaranya adalah Candida albicans, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, Penicillium spp. Candida glabrata, Candida paraspillosis, Candida tropicalis dan Candida kruseii. Terdapat hasil IgG spesifik Aspergillus positif pada subjek penelitian sebanyak 22,1%. Umur dan nilai leukosit berhubungan dengan IgG spesifik Aspergillus dengan nilai (p = 0,048) dan (p = 0,014), sedangkan umur dan jenis kelamin berhubungan dengan biakan Aspergillus dengan nilai (p = 0,027) dan (p = 0,035).

---

Background: Lung cancer patients are prone to fungal infections. Candida and Aspergillus are the most common cause of fungal infections in cancer patients. This study aimed to determine the clinical profile, fungal detection spectrum and level of Aspergillus specific immunoglobulin-G (igG) of new lung cancer patients prior to chemotherapy at Persahabatan Hospital.

Methods: We performed a cross-sectional study, involving NSCLC patients in Persahabatan Hospital whose type of cancer had been established and had not received chemotherapy as subjects. Sputum and serum of the patients was examined for fungus and Aspergillus specific IgG cultures in the Department of Parasitology Faculty of Medicine, Universitas Indonesia. The results of Aspergillus specific fungi and IgG were analyzed to determine their relationship with demographics.

Results: The study included 77 patients as subjects. Sputum culture detected fungi growth in 76 subjects (98.7%). Fungal isolates that grew ≥ 2 species were present in 35 patients (45.5%). Candida albicans (72.3%) and Aspergillus niger (33.8%) were found from the cultures. Positive Aspergillus specific IgG was present in 22.1% of the subjects. There was a significant relationship between age, leukocytes concentration, and level of Aspergillus specific IgG and between age, sex and Aspergillus culture.

Conclusion: The fungi isolates in this study were Candida albicans, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, Penicillium spp. Candida glabrata, Candida paraspillosis, Candida tropicalis and Candida kruseii. Aspergillus specific IgG results were positive in 22.1% of subjects. Age and leukocyte value are associated with Aspergillus specific IgG with (p=0.048) and (p=0.014), and age and sex are associated with Aspergillus culture with (p=0.027) and (p=0.035)."

"Latar Belakang: Aspergilosis paru kronik (APK) dapat menjadi komplikasi infeksi tuberkulosis (TB) paru yang telah diobati. Gejala klinis APK dengan TB paru sangat mirip, sehingga sulit dibedakan. Diagnosis APK ditetapkan sesuai konsensus berdasarkan gejala klinis, hasil pemeriksaan radiologi dan laboratorium mikologi. Pemeriksaan antibodi dengan imunoglobulin G (IgG) spesifik Aspergillus menggunakan metode Enzyme-linked immunosorbent assay (ELISA) dapat membantu diagnosis APK. Penelitian ini bertujuan untuk mengetahui karakteristik klinis, profil IgG spesifik Aspergillus, serta prevalensi APK pada pasien bekas TB di beberapa rumah sakit di Jakarta.Metode: Penelitian prospektif dengan desain potong lintang ini dilakukan pada April 2019 - Februari 2020. Pemilihan subjek dilakukan dengan metode consecutive sampling. Subjek merupakan pasien bekas TB yang berasal dari poli rawat jalan dan rawat inap Rumah Sakit Umum Pusat Rujukan Respirasi Persahabatan Jakarta dan Rumah Sakit Graha Permata Ibu. Pemeriksaan IgG spesifik Aspergillus dan biakan sputum jamur dilakukan di Laboratorium Departemen Parasitologi FKUI.Hasil: Dari 97 pasien yang sesuai dengan kriteria penerimaan, 66 pasien (68%) berjenis kelamin laki-laki dan rerata usia 51,8±13,6 tahun. Gejala klinis lebih dari 3 bulan yang dilaporkan berupa mudah lelah (38,4%), sesak napas (34,02%), batuk (30,93%), hemoptisis (27,84%), penurunan berat badan (23,71%), dan nyeri dada (19,6%). Gambaran radiologi terkait APK berupa ektasis (57,8%), kavitas (27,8%), penebalan pleura (26,8%), fibrosis parakavitas (18,6%), dan bola jamur (6,2%). Hasil pemeriksaan IgG spesifik Aspergillus positif dilaporkan pada 51 pasien (52,6%), sedangkan biakan sputum jamur Aspergillus didapatkan pada 43 pasien (44,3%). Berdasarkan analisis hasil-hasil pemeriksaan tersebut, diagnosis APK ditegakkan pada 28 pasien (28,9%).Kesimpulan: Profil IgG spesifik Aspergillus pada 97 pasien bekas TB dalam penelitian ini menunjukkan hasil positif pada 51 pasien (52,6%). Gejala klinis lebih dari 3 bulan yang dilaporkan berupa batuk lama, hemoptisis, penurunan berat badan, mudah lelah, dan sesak napas. Gambaran radiologi terkait APK berupa ektasis, kavitas, penebalan pleura, fibrosis parakavitas, dan bola jamur. Prevalensi APK berdasarkan hasil-hasil pemeriksaan tersebut adalah 28,9%.

---

Introduction: Chronic pulmonary aspergillosis (CPA) might become a complication of pulmonary tuberculosis (TB) that has been treated. The clinical symptoms of CPA can resemble with PTB, making it difficult to distinguish. The diagnosis of CPA is determined by the consensus based on clinical symptoms, radiological features, and mycological results. Antibody detection with Aspergillus- specific immunoglobulin G (IgG) using the Enzyme-linked immunosorbent assay (ELISA) method can contribute to CPA diagnosis. This study aims to determine the clinical characteristics, Aspergillus-specific IgG detection, and the prevalence of CPA in prior TB patients at several hospitals in Jakarta.

Method: This prospective cross-sectional study was conducted in April 2019 - February 2020. Patients recruitment was carried out by consecutive sampling method. Subjects were prior TB patients at Persahabatan National Respiratory Referral Hospital and Graha Permata Ibu Hospital. Detection of Aspergillus- specific IgG and fungal cultures from sputum were carried out in the Laboratory of the Parasitology Department, FMUI.

Results: Of 97 patients recruited according to inclusion criteria, 66 patients (68%) were male and the mean age was 51.8 ± 13.6 years. The clinical symptoms of more than 3 months were fatigue (38.4%), shortness of breath (34.02%), cough (30.93%), hemoptysis (27.84%), weight loss (23, 71%), and chest pain (19,6%). Radiological features associated with CPA were ectasis (57.8%), cavity (27.8%), pleural thickening (26.8%), para-cavitary fibrosis (18.6%), and fungal ball (6.2%). The Aspergillus-specific IgG positive were reported in 51 patients (52.6%), whereas Aspergillus sputum cultures were found in 43 patients (44.3%). Based on the analysis of those examinations, the diagnosis of CPA was determined in 28 patients (28.9%).

Conclusion: The detection of Aspergillus-specific IgG in 97 prior TB patients showed the positive results in 51 patients (52.6%). The clinical symptoms more than three months were fatigue, shortness of breath, cough, hemoptysis, and weight loss. The radiological features related to CPA were ectasis, cavitary lesions, pleural thickening, paracavitary fibrosis, and fungal ball. The prevalence of CPA based on those examinations was 28.9%."

"Latar belakang: Diagnosis aspergilosis paru invasif (API) cukup sulit dilakukan karena karakteristik klinis dan hasil pencitraan yang tidak spesifik. Biopsi tidak bisa dilakukan karena risiko komplikasi Deteksi antigen galaktomanan (GM) digunakan untuk metode noninvasif karena sensitivitas dan spesifisitas yang tinggi, namun mahal dan jarang tersedia. Uji imunodifusi (IDT) bisa menjadi alternatif karena lebih murah dan mudah, namun perlu diketahui akurasi IDT pada pasien terduga API. Tujuan: Mengetahui nilai diagnostik IDT dibandingkan terhadap deteksi GM dalam mendiagnosis API. Metode: Pengumpulan serum dilakukan di Laboratorium Departemen Parasitologi FKUI sejak Oktober 2019—Oktober 2020 pada pasien terduga API yang berasal dari berbagai rumah sakit di Jakarta. Serum diperiksan menggunakan IDT dan deteksi GM. Metode IDT menggunakan antigen crude Aspergillus buatan Laboratorium Departemen Parasitologi FKUI, sedangkan deteksi GM menggunakan kit PlateliaTM (Bio-Rad, Prancis). Hasil: Sebanyak 92 sampel serum pasien diuji. Proporsi hasil deteksi GM dan IDT berturut-turut sebesar 31.5% dan 42.4%. Hasil menunjukkan bahwa sensitivitas dan spesifisitas IDT berturut-turut sebesar 33.33% dan 69.81%. Selain itu, rasio kemungkinan positif dan negatif berturut-turut sebesar 1.10 dan 0.95. Nilai duga positif dan negatif serta akurasi berturut-turut sebesar 44.83%, 58.73%, dan 54.35%. Tidak ada beda proporsi IDT terhadap deteksi GM (P>0.05) Simpulan: Nilai diagnostik IDT sama dibandingkan terhadap deteksi GM.

---

Background: The diagnosis of invasive pulmonary aspergillosis (API) is quite challenging because of non-specific clinical characteristics and imaging results. A biopsy cannot be performed because of the risk of complications. Galactomannan antigen (GM) detection is used as a noninvasive method because of its high sensitivity and specificity, but it is expensive and rarely available. Immunodiffusion test (IDT) can be an alternative method, because it is cheaper and easier, but it is necessary to know the accuracy of IDT in patients suspected of API.

Objective: Determine the diagnostic value of Aspergillus IDT compared to GM detection in diagnosing API.

Methods: Serum collection was carried out at the Parasitology Laboratory of FMUI from October 2019-October 2020 in patients suspected of API from various hospitals in Jakarta. The sera were examined using the Aspergillus IDT and GM detection. The IDT method uses crude Aspergillus antigen that was conducted at the Parasitology Laboratory of FMUI, while GM detection uses the PlateliaTM kit (Bio-Rad, France).

Results: A total of 92 patient serum samples were tested. The proportion of detection results for GM and IDT was 31.5% and 42.4%, respectively. The results showed that the sensitivity and specificity of IDT were 33.33% and 69.81%, respectively. Also, the positive and negative likelihood ratios are 1.10 and 0.95, respectively. Positive and negative predictive values and accuracy were 44.83%, 58.73%, and 54.35%, respectively. There was no difference in the proportion of IDT to GM detection (P> 0.05).

Conclusion: IDT diagnostic value is the same as compared to GM detection."

"Latar belakang: Aspergilosis paru kronik (APK) merupakan komplikasi yang sering ditemukan pada pasien dengan riwayat tuberkulosis (TB) paru. Pemeriksaan serologi Aspergillus yang cepat dan sensitif dibutuhkan untuk mendiagnosis APK. Penelitian ini membandingkan pemeriksaan serologi ELISA otomatis dan tes imunokromatografi pada dalam mendeteksi antibodi spesifik Aspergillus pada pasien dengan riwayat TB paru.Metode: Studi potong-lintang ini merupakan bagian dari penelitian payung tentang diagnosis APK pada pasien TB. Serum pasien diperiksa menggunakan ELISA otomatis dan tes imunokromatografi. Performa diagnosis diperoleh melalui perbandingan hasil pemeriksaan dengan diagnosis APK. Agreement antar tes dianalisis dengan Hasil: Didapatkan 68 pasien pasca TB dengan median usia 34,5 (17-72) tahun. Sebanyak 24 pasien diadiagnosis APK (35,3%). Proporsi positif ELISA otomatis dan tes imunokromatografi sebesar 48,5% dan 2,9%. ELISA otomatis memiliki sensitivitas 91,7%, spesifisitas 75%, nilai duga positif 66,7%, dan nilai duga negatif  94,3%. Tes imunokromatografi memiliki sensitivitas 8,3%, spesifisitas  dan nilai duga positif 100%, serta nilai duga negatif 66,7%. Agreement antara kedua tes sangat rendah (kappa score: 0,062).Kesimpulan: Pada pasien dengan riwayat TB paru, ELISA otomatis IgG spesifik Aspergillus dapat digunakan sebagai pemeriksaan penunjang APK di area dengan sumber daya mendukung. Sedangkan tes imunokromatografi dapat digunakan sebagai uji penapisan awal APK di daerah dengan keterbatasan sumber daya.

---

Introduction: Chronic pulmonary aspergillosis (CPA) is common in post TB patients. Faster and more sensitive Aspergillus serological examination is necessary for CPA diagnosis. This study compared automated ELISA and immunochromatography test for Aspergillus specific antibody detection in post pulmonary TB patients.

Method: This cross-sectional study is part of previous research on CPA diagnosis in tuberculosis. Patient’s sera were tested with automated ELISA and immunochromatography test. The results were compared to CPA diagnosis to obtain diagnostic performances. The agreement between tests was analyzed with Cohen’s kappa.

Result: There were 68 previous TB patients with median age 34,5 (17-72) years old. CPA was diagnosed in 24 patients (35,3%). The positive result of automated ELISA and immunochromatography test were 48,5% and 2,9%. Automated ELISA showed sensitivity of 97%, specificity of 75%, PPV of 66,7%, and NPV of 94,3%. The immunochromatography test showed sensitivity of 8,3%, specificity and PPV of 100%, and NPV of 66,7%. There was very low agreement between tests (kappa score: 0,062).

Conclusion: Automated ELISA Aspergillus specific IgG could be utilized for supporting CPA diagnosis in post TB patients, mainly in settings where resources are available. Immunochromatography test is applicable as an early screening tool for CPA detection in resource-constrained areas."

"Latar belakang: Aspergilosis paru kronik (APK) merupakan komplikasi yang sering menyebabkan munculnya sekuela respiratori pada pasien bekas tuberkulosis (TB) paru. Diagnosis APK dapat dilakukan dengan pemeriksaan serologi IgG spesifik Aspergillus. Metode tersebut memerlukan waktu tertentu, sumber daya, dan fasilitas khusus, sehingga sulit diterapkan di fasilitas kesehatan dengan sumber daya terbatas. Metode baru Immunocromatography Test (ICT) LD Bio Aspergillus dilaporkan lebih mudah digunakan, cepat dan murah; tetapi akurasi diagnostiknya belum diketahui di Indonesia. Tujuan: Penelitian ini bertujuan untuk mengetahui akurasi diagnostik LD Bio ICT Aspergillus dibandingkan dengan IgG spesifik Aspergillus pada pasien bekas TB. Metode: Penelitian dengan desain potong lintang ini dilakukan dari April 2019 – Oktober 2020. Perekrutan subjek dilakukan di RSUP Persahabatan dan prosedur pemeriksaan mikologi dilakukan di Laboratorium Parasitologi FKUI. Serum pasien bekas TB diperiksa menggunakan LD Bio ICT Aspergillus dan IgG spesifik Aspergillus Dynamiker ELISA. Hasil kedua pemeriksaan dibandingkan untuk melihat akurasi diagnosis LD Bio ICT. Hasil: Dari 82 pasien yang sesuai dengan kriteria inklusi, terdapat 57 pasien (69,5%) laki-laki, rerata usia pasien 51,27±12,55 tahun. Median IMT 18,67 (10,38-31,18). Sebanyak 40 pasien (48,7%) menunjukkan hasil positif IgG spesifik Aspergillus. Adapun hasil positif LD Bio ICT Aspergillus didapatkan pada 35 pasien (42,7%). Sensitivitas dan spesifisitas LD Bio ICT dibandingkan dengan pemeriksaan IgG spesifik Aspergillus adalah 50,0% dan 64,3%, sedangkan nilai duga positif dan negatifnya adalah 57,1% dan 57,5%. Simpulan: LD Bio ICT dapat digunakan untuk mendiagnosis APK pada pasien bekas TB Paru di fasilitas kesehatan dengan sumber daya terbatas.

---

Background: Chronic pulmonary aspergillosis (CPA) is a common complication following prior pulmonary tuberculosis (TB) causing respiratory sequelae. Although CPA may lead to worse prognosis, it is still underdiagnosed. Serology test such as Aspergillus-specific IgG is the recommended test for CPA diagnosis. However, this diagnostic procedure is time-consuming, require a lot of resources and certain skills, making this procedure not always easy to implement in limited facilities. The LDBio Diagnostic introduced a novel, affordable, and easy to use serology test, LD Bio Immunocromatography Test (ICT). Nevertheless, LD Bio ICT’s diagnostic accuracy in Indonesia is still unknown.

Study aims: This study aimed to determine the diagnostic accuracy of LD Bio ICT with Aspergillus-specific IgG as comparison in previous pulmonary TB patients.

Methods: This cross-sectional study was conducted in April 2019 – October 2020. Subject recrutment was done in National Referral Centre Persahabatan Hospital and serological test was conducted in the Parasitology Laboratory, Faculty of Medicine Universitas Indonesia. Eighty two sera of previous pulmonary TB patients were serologically tested using LD Bio ICT Aspergillus (France) and Aspergillus-specific IgG was tested using Dynamiker ELISA kit. Results of both tests were then compared to determine the diagnostic accuracy of LD Bio ICT.

Results: Of 82 patients met the inclusion criteria, 57 patients (69.5%) were men, the mean age was 51.27±12.55 years old. The BMI median was 18.67 (10.38-31.18). Forty patients (48.7%) showed positive Aspergillus-specific IgG Dynamiker results. Meanwhile, 35 patients (42.7%) showed positive results of LD Bio ICT Aspergillus. Compared to this finding, LD Bio ICT sensitivity and specificity were 50.0% and 64.3% respectively. In addition, the positive and negative prediction value of LD Bio ICT in this study were 57.1% and 57.5%.

Summary: LD Bio ICT is useful for the diagnosis of CPA in previous pulmonary TB patients in resource-limited settings."

"Latar belakang: Indonesia memiliki beban tuberkulosis (TB) paru tinggi. Aspergilosis paru kronik (APK) sering ditemukan pada pasien TB. Diagnosis APK menjadi tantangan di Indonesia karena keterbatasan sumber daya. Diperlukan alat diagnostik yang mudah, murah, dan memberikan hasil cepat dengan akurasi baik untuk membantu menegakkan diagnosis APK. Penelitian ini bertujuan untuk mengetahui nilai diagnostik ICT Aspergillus pada pasien TB paru.Metode: Penelitian ini berdesain potong lintang dan merupakan bagian dari penelitian payung tentang diagnosis APK pada pasien TB paru di Jakarta. Serum pasien TB paru yang memenuhi kriteria inklusi diperiksa menggunakan ICT Aspergillus (LDBio, Diagnostics, Lyon, France) dan IgG Spesifik Aspergillus ELISA (Bordier affinity products, Crissier, Switzerland) sesuai protokol di Laboratorium Mikologi Departemen Parasitologi FKUI pada Februari-November 2021.Hasil: Dari 105 subjek penelitian yang memenuhi kriteria inklusi, sebanyak 58,1% adalah laki-laki. Rerata usia pasien 47,1617,1 tahun. Proporsi hasil positif ICT Aspergillus adalah 10,5% dan IgG spesifik Aspergillus ELISA 43,8%. Sensitivitas ICT Aspergillus 23,9%, dengan spesifisitas 100%, nilai duga positif 100%, dan nilai duga negatif 62,8%.Kesimpulan: Kemampuan diagnostik ICT Aspergillus belum optimal sebagai alat skrining, tetapi dapat dipertimbangkan sebagai alat diagnosis pasien TB paru suspek APK pada daerah dengan sumber daya terbatas.

---

ackground: Indonesia has high pulmonary tuberculosis (TB) burden. Chronic pulmonary aspergillosis (CPA) is common in pulmonary TB patients. Diagnosing CPA is challenging in Indonesia because of the limited resources available. A new rapid and robust diagnostic tool is needed. This research aims to evaluate the diagnostic value of the ICT Aspergillus in pulmonary TB patients.

Methods: This cross-sectional study is a part of the CPA diagnostic research of pulmonary TB patients. Pulmonary TB patients' serum fulfilling the inclusion criteria were assessed using ICT Aspergillus (LDBio, Diagnostics, Lyon, France) and Aspergillus-specific IgG ELISA (Bordier affinity products, Crissier, Switzerland) in Mycology Laboratory of Parasitology Department FMUI in February-November 2021.

Results: From 105 subjects included, the proportion of men 58,1% with 47,1617,1 years age means. The Aspergillus IgG was positive in 10,5% patients with ICT, and 43,8% with ELISA. The sensitivity of ICT Aspergillus was 23,9%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 62,8%.

Conclusion: ICT Aspergillus has a fair diagnostic capacity in pulmonary TB patients as screening tools for CPA. However, the usage of ICT Aspergillus as point-of-care test in limited-resource settings needs to be considered."