UNIVERSITAS AIRLANGGA



Detail Article

Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 21 / No. 2 / Published : 2015-03

Order : 6, and page :135 - 137

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Original Article :

Diagnosis of pulmonary tuberculosis based on frequency of sputum examination

Author :

  1. Larissa*1
  2. Ida Parwati*2
  3. A K Sugianli*3
  1. PPDS-1 Patologi Klinik, Fakultas Kedokteran, Universitas Padjadjaran, Bandung. E-mail
  2. Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Padjadjaran, Bandung
  3. Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Padjadjaran, Bandung

Abstract :

Nowadays in Indonesia, three times (first spot-second in the morning-third spot) microscope sputum examination to find acid fast bacilli is used to diagnose pulmonary tuberculosis (TB). WHO policy (2007) recommends a reduction of sputum smears from three up to two times. The International Standards for Tuberculosis (2009) stated that the suspected pulmonary TB patients should have at least two sputum specimens for microscopic examination with one early morning sputum. The aim of this study is to know whether pulmonary TB can be confirmed only by two sputum specimen in the investigation. The subjects consist of patients who were examined three times of their sputum at the Microbiology Laboratory of Clinical Pathology Department, at Hasan Sadikin Hospital from 2011–2012 (2 years period). This study used analytical retrospective method, with investigation agreement between the two first sputum (one of the specimen was the morning sputum) with the third sputum using kappa coefficient and McNemar test. During the study between 2011–2012, there were examined 3744 TB suspected patients. There is an excellent agreement (k=0.835) between the two times examination of the first sputum and the third one. The positive possibility of the third sputum when the first two specimens were negative is only 1.7% (p=0.000). Based on this study there is an excellent agreement between the two times sputum examination with the third one. That means two sputum specimen can be used for the confirmation of pulmonary TB. Saat ini di Indonesia, penetapan diagnosis Tuberkulosis (TB) melalui pemeriksaan mikroskopis Basil Tahan Asam (BTA) dilakukan dengan tiga spesimen dahak; sewaktu-pagi-sewaktu. Kebijakan WHO tahun 2007 menyarankan pengurangan jumlah spesimen dahak yang diperiksa dari tiga menjadi dua kali. International Standards for Tuberculosis Care tahun 2009 menetapkan pasien yang diduga TB paru setidak-tidaknya memeriksakan dua kali dahak untuk pemeriksaan mikroskopis yang salah satunya adalah dilakukan pada pagi hari. Tujuan penelitian ini adalah untuk mengetahui apakah untuk penetapan diagnosis TB paru cukup hanya dengan dua (2) kali pemeriksaan dahak. Subjek penelitian adalah pasien yang diduga TB dan diperiksa dahaknya tiga kali ke laboratorium Mikrobiologi Klinik Departemen Patologi Klinik RSUP Dr. Hasan Sadikin Bandung masa waktu antara tahun 2011−2012 (2 tahun). Metode penelitian ini adalah tinjauan ke belakang terkait analisis dengan menguji kesesuaian hasil memeriksa dua dahak pertama (salah satunya diambil pagi) dengan yang ke-3 menggunakan koefisien Kappa dan uji McNemar. Selama masa waktu antara tahun 2011–2012 didapatkan 3744 pasien yang terduga TB yang memeriksakan dahak BTA tiga kali. Didasari analisis, didapatkan kesesuaian yang sangat baik (excelent agreement, k=0,835) antara dua kali pemeriksaan dahak pertama dan yang ke-3. Kemungkinan dahak ke-3 positif apabila pemeriksaan dua sebelumnya negatif hanya sebesar 1,7% (p=0,000). Hasil memeriksa dahak BTA dua kali sesuai dengan yang ke-3, sehingga dua kali pemeriksaan saja sudah dapat digunakan untuk penetapan diagnosis TB paru.

Keyword :

Two times sputum, third sputum, pulmonary tuberculosis,


References :

Kementerian Kesehatan Republik Indonesia,(2011) Pedoman Nasional Pengendalian Tuberkulosis 12–4 : Kesehatan Republik Indonesia

World Health Organization,(2007) Reduction of number of smears for the diagnosis of pulmonary TB 1–3. : World Health Organization





Archive Article

Cover Media Content

Volume : 21 / No. : 2 / Pub. : 2015-03
  1. Pneumatic tube on routine blood test and lactate dehydrogenase
  2. Detection in tetrazolium microplate assay culture methods from pulmonary tuberculosis suspected sputum
  3. High molecular weight adiponectin and vasculer thickness in diabetes type 2 related to fixed dose combination of glimepiride and metformin
  4. Neutrofil/lymphocyte ratio in carcinoma mammae
  5. Platelet aggregation and mean volume with metabolic syndrome in obesity
  6. Diagnosis of pulmonary tuberculosis based on frequency of sputum examination
  7. Genetic variation of hepatitis b virus polymerase gene from chronic hepatitis b infected patient with telbivudine therapy
  8. The 38 kda adhesin protein of mycobacterium tuberculosis and macrophage of the lung
  9. Bacterial pattern and patient’s age on procalcitonin in community and hospital acquired pneumonia
  10. Aspergillus glaucus group and penicillium sp in neurosurgery operating theater
  11. Diagnostic value of iga antivca epstein-barr antibody in nasophryngeal carcinoma
  12. Blood glucose test between hexokinase with glucose oxidase and glucose dehydrogenase methods in diabetes mellitus
  13. β-thalassemia trait using capillary electrophoresis
  14. Lipoprotein(a) in acute coronary syndrome
  15. D-dimer plasma levels in ishemic stroke
  16. Adrenomedullin’s in breast cancer with metastatic state
  17. Storage temperature for 24 hours of uric acid in urine
  18. Ebola virus disease
  19. Congenital malaria

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