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[Latar belakang. Frambusia banyak ditemukan di negara tropis dan 75% kasus baru terdeteksi pada anak kurang dari 15 tahun. Diagnosis klinis sulit karena dapat menyerupai lesi penyakit lain. Namun pada praktiknya, diagnosis lebih sering ditegakkan berdasarkan temuan klinis dan epidemiologis, karena pemeriksaan serologis dianggap tidak praktis. Tujuan. Mengetahui kesesuaian gambaran klinis frambusia menurut pedoman WHO dengan kepositivan TPHA pada anak usia 1-12 tahun. Metode. Uji deskriptif. Subyek penelitian dilakukan pemeriksaan klinis sesuai lesi frambusia menurut WHO, lalu dikategorikan sebagai terduga frambusia dan bukan frambusia. Seluruh subyek dikonfirmasi dengan pemeriksaan TPHA. Dihitung besar kesesuaian keseluruhan, kesesuaian positif, dan negatif antara dugaan klinis dan TPHA. Hasil. Total subyek penelitian adalah 493 anak. Sebanyak 32 subyek terduga klinis frambusia dan 22 subyek dengan hasil TPHA positif. Proporsi kesesuaian keseluruhan antara gambaran klinis WHO dan TPHA adalah 90,67%, dengan proporsi kesesuaian positif 18,18%, dan proporsi kesesuaian negatif 94,06%. Kesimpulan. Nilai kesesuaian keseluruhan yang tinggi disebabkan karena kepositivan TPHA sangat kecil dibandingkan total subyek. Kepositivan gambaran klinis frambusia menurut WHO hanya memiliki kesesuaian sebesar 18,18% dengan pemeriksaan TPHA, sehingga tidak cukup sebagai sarana penapisan penyakit. Tidak ditemukannya gambaran klinis menurut WHO memiliki kesesuaian sebesar 94,06% dengan TPHA yang negatif., Background. Yaws is most prevalent in tropical countries and 75% of new cases are in children younger than 15 years. Clinical diagnosis can be confused with other skin diseases. However, physician often diagnose the disease based on clinical and epidemiological finding, because serological examination is impractical. Aim. To identify the conformity of yaws’ clinical manifestation based on WHO classification and TPHA in children age 1-12 years. Method. Descriptive study. All subjects were examined based on WHO classification, and then categorized as suspected or nonsuspected cases. TPHA were done to all subjects. Data collected were calculated to identify the proportion of overall agreement, positive percent agreement and negative percent agreement between clinical diagnosis and TPHA. Result. 493 subjects included in this study. There were 32 subjects with suspected yaws and 22 with reactive TPHA. The proportion of overall agreement between suspected case and TPHA were 90,67%, with positive percent agreement of 18,18%, and negative percent agreement of 94,06%. Conclusion. The high value of overall agreement can be due to rare case compared to total subjects. The positiveness of yaws’ clinical manifestation based on WHO classification only had the conformity of 18,18% with TPHA result, which means that clinical diagnosis alone is nonreliable as screening tool. The negativeness of the clinical manifestation had the conformity of 94.06% with TPHA result.] |
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