Electronic Theses and Dissertation

Pendahuluan: Tuberkulosis (TB) masih menjadi masalah kesehatan global yang signifikan, terutama dengan munculnya kasus TB resisten obat (TB-RO). Rasio monosit limfosit (RML) telah diidentifikasi sebagai biomarker potensial dalam berbagai kondisi inflamasi, namun perannya dalam membedakan TB sensitif obat (TB-SO) dan TB-RO serta korelasinya dengan bacterial load masih perlu dieksplorasi lebih lanjut.
Metode: Penelitian ini merupakan studi retrospektif untuk melihat korelasi antara RML dan bacterial load tuberkulosis pada penderita TB-SO dan TB-RO. Bacterial load dinilai menggunakan nilai ct-value pada pemeriksaan Tes Cepat Molekuler (TCM), sedangkan RML dihitung dari hasil pemeriksaan laboratorium saat diagnosis. Analisis statistik, termasuk uji spearman dan Area Under Curve (AUC) pada Receive Operating Curve (ROC), dilakukan dengan tingkat keyakinan 95%. Hasil: Sebanyak 137 subjek dilibatkan dalam penelitian ini, dengan 106 subjek kelompok sensitif obat dan 31 subjek kelompok resisten obat. Analisis statistik menggunakan uji spearman menunjukkan korelasi positif yang kuat antara bacterial load dengan RML. Nilai cut-off RML optimal adalah 0,90 dengan sensitivitas 71% dan spesifisitas 60%. Pasien dengan RML di bawah nilai mean cenderung merupakan pasien TB-SO, mengindikasikan potensi RML sebagai biomarker pembeda antara TB-SO dan TB-RO.
Kesimpulan: RML berkorelasi dengan bacterial load pada pasien TB dan memiliki potensi sebagai biomarker tambahan untuk membedakan TB-SO dan TB-RO.

Kata kunci: Tuberkulosis, Sensitif Obat, Resisten Obat, Rasio Monosit Limfosit,
Bacterial load

Introduction: Tuberculosis (TB) remains a significant global health concern, particularly with the emergence of drug-resistant TB (DR-TB) cases. The monocyte-lymphocyte ratio (MLR) has been identified as a potential biomarker in various inflammatory conditions; however, its role in distinguishing between drug- sensitive TB (DS-TB) and DR-TB, as well as its correlation with bacterial load, requires further exploration. Method: This retrospective study investigated the correlation between MLR and tuberculosis bacterial load in DS-TB and DR-TB patients. Bacterial load was assessed using ct-value from Rapid Molecular Test, while MLR was calculated from laboratory results at the time of diagnosis. Statistical analysis, including Spearman's correlation test and Area Under Curve (AUC) on Receiver Operating Curve (ROC), was performed with a 95% confidence interval. Results: A total of 137 subjects were included in this study, comprising 106 drug- sensitive and 31 drug-resistant subjects. Statistical analysis using Spearman's test revealed a strong positive correlation between bacterial load and MLR. The optimal MLR cut-off value was 0.90, with 71% sensitivity and 60% specificity. Patients with MLR below the mean value tended to be DS-TB patients, indicating MLR's potential as a biomarker for distinguishing between DS-TB and DR-TB. Conclusion: MLR correlates with bacterial load in TB patients and shows potential as an additional biomarker for distinguishing between DS-TB and DR-TB. Keywords: Tuberculosis, Drug-Sensitive, Drug-Resistant, Monocyte-Lymphocyte Ratio, Bacterial Load