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Scoping Review: Rasio Monosit Limfosit sebagai Penunjang untuk Menegakkan Diagnosis pada Penderita Tuberkulosis
Abstract
Tuberkulosis (TB) merupakan penyakit yang disebabkan oleh Mycobacterium tuberculosis. Indonesia menempati urutan ketiga kasus TB terbanyak di dunia. Pemeriksaan bakteriologis menjadi standar untuk menegakkan diagnosis tuberkulosis. Keterbatasan pemeriksaan kultur bakteri adalah membutuhkan waktu yang lama, sedangkan pemeriksaan TCM tidak selalu menunjukkan bakteri masih hidup. Pemeriksaan imunologis interferon-γ release assays (IGRA) memiliki harga mahal dan membutuhkan alat khusus. Pemeriksaan hematologi rutin mudah dilakukan sehingga memiliki potensi menunjang penegakan diagnosis TB berdasar atas parameter imunologis. Tujuan penelitian ini adalah melakukan literature review untuk mengidentifikasi potensi rasio monosit limfosit (MLR) sebagai penunjang diagnosis TB. Pencarian artikel dilakukan secara online dari database Pubmed, Springer Link, dan Science Direct. Tahapan penyaringan artikel mengikuti alur PRISMA. Pada tahap akhir, artikel yang eligible dipilih berdasar atas kriteria patient, intervention, comparison, outcome, and study (PICOS), yaitu pasien TB, rasio monosit limfosit, diagnosis TB, dan original study. Hasil penelitian ini mendapatkan tujuh artikel dari jumlah awal 8.942 artikel yang ditemukan dari kata kunci. Dua dari tujuh artikel menyatakan MLR dapat menunjang diagnosis TB. Dua artikel menunjukkan monosit dan limfosit dapat menjadi penanda infeksi bakteri termasuk TB. Satu artikel menyatakan hubungan TB dengan penurunan produksi sitokin monosit dan limfosit. Dua artikel menyatakan MLR tidak ada hubungan dengan kasus TB. Terdapat satu artikel yang menyatakan batas nilai MLR 0,378 untuk menunjang diagnosis TB. Penelitian observasional tentang MLR untuk menunjang diagnosis TB di Indonesia masih perlu dilakukan terutama pengkajian batas nilai MLR.
SCOPING REVIEW: MONOCYTE LYMPHOCYTE RATIO AS SUPPORT TO ENFORCE ON PATIENT TUBERCULOSIS
Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis. Indonesia ranks third with the most TB cases in the world. A bacteriological examination is a standard for diagnosing TB. A bacteriological examination is a standard for establishing the diagnosis of tuberculosis. The limitation of bacterial culture examination is that it takes a long time, while TCM examination does not always show the bacteria are still alive. Interferon-γ release assays (IGRA) examinations are expensive and require special equipment. Routine hematology tests are easy to do so as they have the potential to support the diagnosis of TB based on immunological parameters. The purpose of this study was to conduct a literature review to identify the potential for monocyte lymphocyte ratio (MLR) to support the diagnosis of TB. Search for articles was conducted online from PubMed, Springer Link, and Science Direct databases. The steps of filtering articles follow the PRISMA flow. In the final stage, eligible articles were selected based on patient, intervention, comparison, outcome, and study (PICOS) criteria, namely TB patient, monocyte lymphocyte ratio, TB diagnosis, and the original research. The results of this study obtained seven articles from 8,942 articles found from keywords. Two of the seven articles said that MLR could support the diagnosis of TB. Two articles showed that monocytes and lymphocytes could be markers of bacterial infection include TB. One article said the association of TB with decreased production of monocyte and lymphocyte cytokines. Two articles said that MLR had no relationship with TB cases. There is one article that states the MLR value limit is 0.378 to support the diagnosis of TB. Observational research on MLR to support the diagnosis of TB in Indonesia still needs to be done, especially the assessment of the limit of the MLR value.
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DOI: https://doi.org/10.29313/jiks.v3i2.7501
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