PRIHATINI, - (1996) PENILAIAN KEGUNAAN POLYMERASE CHAIN REACTION (PCR) DALAM DIAGNOSIS DEMAM TIFOID. Disertasi thesis, UNIVERSITAS AIRLANGGA.

Text 7. PENILAIAN KEGUNAAN.pdf Download (6MB)

Abstract

An investigation was carried out on Polymerase Chain Reaction (PCR) a laboratory diagnostic tool based on biomolecular reaction, which supposed could overcome the difficulties in the detection of microbial etiology that cause an infectious disease in an endemic area. The back ground of the study was that the laboratory test routinely used in the government and private hospitals or others often facing difficulties in the detection of the cause which support the diagnosis. Which concluded whether the cause was from S. typhi origin or not. In serological test the result also did not support the diagnosis of the disease when it happened in an endemic area like Indonesia. Nowadays, there are many factors that influenced the validity of the conventional laboratorical test, so that the results come to doubt and the treatment will be misconducted. In addition, the routine laboratorical test may also take several days before arrived to a conclusion and some times the test has to be repeated because of those contaminant factors mentioned above. That was why an effort was carried out by a study in the clinical laboratory test with a biomolecular design approach. The objective of this study was to obtain information about PCR test particularly the evaluation of its usage, whether this test as a supporting diagnostic tool in the diagnosis of typhoid fever has the same level or different with the routinely used Widal serological test. The later test, up to now is still in use as a supporting diagnostic tool for the confirmation of the fever to endemic as well as non endemic population. Solely the PCR test has a high accuracy and precision and has a particular advantage in comparison with other laboratorical tests that routinely used by the hospital laboratory, to trace the S. typhi DNA. Statements of the problem of this study consist of the following questions: Could PCR test result increase the sensitivity as well as the specificity in the detection of S. typhi compared to culture test from blood sample taken in an endemic area? Is PCR test result in diagnosing typhoid fever more sensitive and specific compared to Widal serological test? This investigation has been carried out by using two kinds of polulations: Firstly, those patients clinically suspected as suffering typhoid fever. Secondly those patients clinically as well as laboratorically suspected suffering non typhoid fever; whose criterion and condition defined at any age: from babies till adults. The blood 254 samples were examined at Dr. Soetomo Hospital Surabaya and at Institute of Higher Education University of Malaya Kualalumpur Malaysia. The findings were summarized after statitiscally analyzed by McNemar and Yates correction (p = 0.05). From this study can be concluded that both laboratory tests had a significant difference (p < 0.001) as well as for the efficiency of the diagnosis, the positive or negative prognosis's evaluation approaching 100%. That means the PCR test may used as a supporting tool for the confirmation of the diagnosis. From this study so far, can be concluded that the aim of the investigation to get the information for a guidance in the clinical laboratory test succeeded. The results showed: I.PCR test is useful in the detection of typhoid fever and may use as a gold standard, 2.PCR test is useful to solve the problem in the difficulty of the confirmation of cases.

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