Nilai Diagnostik Indikator Fisik Dibandingkan Baku Emas Untuk Menegakkan Diagnosis Terduga Kretin Pada Batita

Abstract

Iodine severe deficiency is a major cause of impairment due to iodine deficiency disorders. Cretinism is a consequence of iodine deficiency in the womb with clinical signs that stand out among others is mental retardation. In Indonesia, there were many cases of endemic goiter and cretinism. Diagnosis of cretinism can be established more accurately by laboratory tests, but it is expensive and less practical when conducted the field. Currently there are available tools for early detection for hypothiroid in neonates (NHI, Quebec) less expensive and easier to implement however it can not be used for older children. The instrument need to be developed for older children that was easy, deap and can provide a reliable diagnostic result. This diagnostic test research studied the diagnostic value of physical indicators for the diagnosis of suspected cretinism in infants and toddlers. The research was conducted in Magelang, Wonosobo, Wonogiri and Ponorogo Districts, for 10 months. Subject were infants and children under three years old. The information generated in the form of cretinism suspected early detection instrument (DDSK) for infant and toddler at the community level. The proportion of subjects with high TSH and low FT4 (hypothyroid) were 4.6% and 98.8%. The proportion of subjects experiencing developmental disorder were 36.4% (Denver test); impaired function of hearing were 2.7% and impaired motor function were 5.5%. The result of diagnosis using DDSK form, subjects detected cretinism suspected of 11.9%, and the diagnostic gold standard (the combined test results of Denver, Bayley, clinical examination and laboratory) of 11.3%. There is a significant relationship (p< 0.001) between the presence of positive test results with cretinism suspected; grades Se= 47.1%, Sp= 92.5%. Compare with gold standard, physical indicators of diagnostic test (DDSK) could diagnosed suspected cretinism among children under three years. Revising components and scoring in the indicators of cretinism suspected early detection instrument (DDSK) for infant and toddler were necessary