SISTEM SKORING UNTUK MENEGAKKAN DIAGNOSIS SECARA KLINIS DIARE CAIR AKUT ROTAVIRUS PADA ANAK BALITA

SAMAD, Prof. dr. Srisuparyati Soenarto, Ph.D, Sp.A(K)

2016 | Tesis | S2 Kedokteran Klinik/EK

Latar belakang : Sampai saat inidiare cair akut rotavirus masih merupakan penyebab kesakitan dan kematian pada anak balita diseluruh dunia, di Indonesia terdapat 10.651 anak meninggal tiap tahun dengan beban biaya langsung maupun tidak langsung sebesar 19,5 juta dolar.Sebagian besar gejala diare cair akut rotavirus adalah muntah yang berulang, berak cair hebat, dehidrasi dan demam .Tujuan : membuat diagnosis klinis diare cair akut rotavirus pada anak balita dengan menggunakan sistem skoring.Metode cross-sectional denganuji diagnostik menggunakan adjustedlikehood ratiountuk pembuatan skoring. Hasil : didapatkan 1148 subjek dengan perincian 55 subyek rawat jalan , 5 subyek tidak ada data dan 1088 subyek rawat inap, dari data tersebut ada 488 subyek (42,50%) fesesnya mengandung rotavirus. Hanya ada satu variabel likelihood ratio yang memenuhi kriteria untuk dilakukan adjusted likelihood ratio yaitu dehidrasi :unadjusted LR [(+) 1.24 ; (-) 0.46] dan adjusted LR [(+) 1.18 ; (-) 0.55] setelah dilakukan konversi dengan logaritma didapatkan skor 0 bila ada dehidrasi dan (-) 1 bila tidak ada dehidrasi. Simpulan : Sistem skoring tidak dapat dibuat dengan menggunakan data surveillance cross-sectional study.Tidak adanya dehidrasipada anak balita yang menderita diare cair akut bisa digunakan untuk menyingkirkan kemungkinan penyebabnya bukan karena infeksi rotavirus cukup baik. Kata kunci : Rotavirus, sistem skoring, likelihood ratio.

Background :Nowadays, acute rotavirus diaorrhea is oneof the major causes of morbidity and mortality of children in the world with approximately 10.651 children died in Indonesia with direct and indirect burden costs were about 19.5 millions dolar. The most common frequent signs of this viral infection are vomitting, profuse watery diaorrhea, dehydration, and fever. Objective : To develop scoring system for diagnosing acute diaorrhea rotavirus. Method : Cross sectional and adjusted likelihood ratio were done in this study. Result: In total, 1148 subjects were acquired with divided into 55 outpatient clinic subject and 1088 ward subject. Five subjects were not analysed due to incomplete data. From all analysed subjects, 488 subjects (42.5%) feces were contained rotavirus. There was only one likelihood ratio variable which fulfill the criteria for being adjusted likelihood ratio that is dehydration: unadjusted LR [(+) 1.24 ; (-) 0.46] and adjusted LR [(+) 1.18 ; (-) 0.55]. Furthermore, conversion with logarithm was done yielding 0 score if dehydration was found and (-) 1 if no dehydration was found. Conclusion : This study shows that dehydration in children with acute diaorrhea can be used to exclude any possibility of rotavirus infection. However, scoring system could not be produced by using surveillance cross sectional study. Keywords : rotavirus, scoring system, likelihood ratio

Kata Kunci : rotavirus, scoring system, likelihood ratio.