SCREENING PASIEN SUSPEK DEMAM TIFOID DENGAN WIDAL TES DAN RAPID TEST IgM ANTI-SALMONELLA DAN RASIO MONOSIT–LIMFOSIT (MLR)

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Typhoid fever is an infectious disease caused by Salmonella typhi and remains a major public health problem in Indonesia. The diagnosis of typhoid fever is generally confirmed through serological tests such as the Widal test and the anti-Salmonella IgM rapid test. Both tests are commonly used, but they have limitations in sensitivity and specificity. The monocyte-lymphocyte ratio (MLR) is a hematological parameter that has the potential to serve as a supportive indicator because it reflects both innate and adaptive immune responses. The objective of this study was to analyze the relationship between the monocyte-lymphocyte ratio (MLR) and the Widal test and anti-Salmonella IgM rapid test in patients with suspected typhoid fever. This study was conducted using an observational analytical method with a cross-sectional design. The study sample consisted of 29 patients with suspected typhoid fever at the Klinik Ultra Medica in Tulungagung, selected through purposive sampling. The results showed that MLR values fell into the low category in 79.3% of cases, moderate in 17.2%, and high in 3.4%. The anti-Salmonella IgM rapid test results showed 37.9% positive and 62.1% negative. The Widal test results were dominated by a titer of 1/80 (79.3%) and a titer of 1/160 (13.8%). Spearman's rank correlation test yielded r = 0.200 (p = 0.298) between MLR and anti-Salmonella IgM rapid test, and r = -0.133 (p = 0.490) between MLR and Widal test. In conclusion, there is no significant association between the monocyte-to-lymphocyte ratio (MLR) and the results of either the Widal test or the anti-Salmonella IgM rapid test in patients with suspected typhoid fever (p > 0.05). ABSTRAK Demam tifoid merupakan penyakit infeksi yang disebabkan oleh bakteri Salmonella typhi dan hingga saat ini masih menjadi masalah kesehatan masyarakat di Indonesia. Penegakan diagnosis demam tifoid umumnya dilakukan melalui pemeriksaan serologi seperti tes Widal dan rapid test IgM anti-Salmonella. Keduanya masih sering digunakan, namun memiliki keterbatasan sensitivitas dan spesifisitas. Rasio monosit-limfosit (Monocyte-Lymphocyte Ratio / MLR) merupakan parameter hematologi yang berpotensi menjadi indikator pendukung diagnosis demam tifoid karena mencerminkan respons imun bawaan dan adaptif. Penelitian ini bertujuan untuk menganalisis hubungan rasio monosit-limfosit (MLR) dengan tes Widal dan rapid test IgM anti-Salmonella pada pasien suspek demam tifoid. Penelitian ini menggunakan metode observasional analitik dengan desain cross-sectional. Sampel penelitian berjumlah 29 pasien suspek demam tifoid di Klinik Ultra Medica Tulungagung yang dipilih secara purposive sampling. Hasil penelitian menunjukkan nilai MLR berada pada kategori rendah 79,3%, sedang 17,2%, dan tinggi 3,4%. Hasil rapid test IgM anti-Salmonella menunjukkan 37,9% positif dan 62,1% negatif. Hasil tes Widal didominasi oleh titer 1/80 sebesar 79,3% dan titer 1/160 sebesar 13,8%. Hasil uji korelasi Spearman Rank antara MLR dengan rapid test IgM anti-Salmonella menghasilkan ( ), sedangkan antara MLR dengan tes Widal menghasilkan ( ). Dengan demikian, tidak terdapat hubungan yang signifikan antara rasio monosit-limfosit (MLR) dengan hasil tes Widal maupun rapid test IgM anti-Salmonella pada pasien suspek demam tifoid ( ).

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.