CHILDHOLD

TUBERCULOSIS

Presentan: Pembimbing:
Irma Sari Muliadi Dr. Pulung M Silalahi, Sp.A
41151096100088

KEPANITRAAN KLINIK ILMU KESEHATAN ANAK DAN REMAJA

RUMAH SAKIT TK. I SAID SUKANTO
PROGRAM STUDI PENDIDIKAN DOKTER
FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN
UNIVERSITAS ISLAM NEGERI SYARIF HIDAYATULLAH
JAKARTA
2018
 INTRODUCTION

 Children higher risk for severe TB such

as Milier TB and Meningitis TB which
can lead to higher morbidity and
mortality in children.1
 Children are also very susceptible TB
especially close contact with patients
smear-positive TB.1
 DEFINITION

Tuberculosis (TB)
is an infectious disease
caused by Mycobacterium
tuberculosis.
EPIDEMIOLOGY
ETIOLOGY
 Aerobics

 Shaped: stem

 Length: 1-4/µm

 Thickness: 0,3 – 0,6/µm

 Pathogens & Acid

Resistance

 Optimal Temperature: 37 –
41 0C
PATHOGENESIS

 Nastiti NR, Bambang S, dan Darmawan BS.

Buku Ajar Respirologi Anak. Edisi ke-1. Badan
Penerbit IDAI: Jakarta; 2008.

 Nastiti NR, Darfioes R, Makmuri MS, Cissy BK.

Pedoman Nasional Tuberkulosis Anak. Edisi ke-
2. Badan Penerbit IDAI: Jakarta; 2008.
PERJALANAN
ALAMIAH

Nastiti NR, Darfioes R, Makmuri

MS, Cissy BK. Pedoman Nasional
Tuberkulosis Anak. Edisi ke-2.
Badan Penerbit IDAI: Jakarta; 2008.
 ENFORCEMENT OF
DIAGNOSIS
Anamnesis

 Reduced weight 2 months in a row

for no cause
 Fever for no apparent reason
 Chronic cough> 3 weeks
 Contact history with adult lung TB
patients
8
 ENFORCEMENT OF
DIAGNOSIS
Physical examination

 Enlarged lymph glands

 Progressive swelling or bone
deformity, joints, knees, phalanges
 Weight measurements by age

9
 ENFORCEMENT OF
DIAGNOSIS
Supporting investigation

a) Tuberculin test
b) Radiology
c) Microbiology
d) Anatomical Pathology
10
 SCORING DIAGNOSIS SYSTEM
OF CHILDHOLD TUBERCULOSIS

11
 TUBERCULOSIS
SCREENING CHART
 CLINICAL
MANIFESTATION
 1. Older fever (> 2 weeks) and / or recurring for no
apparent reason
 2. Weight loss for no apparent reason
 3. Anorexia
 4. Enlarged superficial lymph nodes
 5. Long cough for more than 3 weeks
 6. Persistent diarrhea that does not heal
 7. Malaise (tired, lethargic, weak, tired)
13
 OTHER
MANIFESTATION
 Depending on which organs are affected

Skrofuloderma
 Chest pain due to fluid in the pleura cavity

 Symptoms such as bone infection

 High fever, decreased awareness and convulsions

(tuberculosis meningitis)

14
 PREVENTION

1. BCG Vaccination

2. Chemoprophylaxis

- Primary

- Secondary

15
 THERAPHY

Kemenkes RI. Petunjuk Teknis Manajemen dan Tatalaksana TB Anak. Jakarta:

Kemenkes RI, 2016.
 THERAPHY

Kemenkes RI. Petunjuk Teknis Manajemen dan Tatalaksana TB Anak. Jakarta:

Kemenkes RI, 2016.
 EVALUATION OF
THERAPHY
1. CLINICAL
the disappearance / improvement of clinical
abnormalities that existed earlier in treatment.

2. RADIOLOGY
n the treatment of 2-3 months of improvement in
radiological features.

3. LED
evaluation when the initial treatment of high value.
 DOTS APPROACH

1. Political commitment from decision makers,

including the financial support.
2. The diagnosis of TB by sputum microscopic
examination.
3. Treatment with short-term OAT guidance with
direct supervision by the drug controller (PMO).
4. Continuity of supply of short-term OAT with
quality guaranteed.
5. Recording and reporting standard for monitoring
and evaluation of TB control programs.
 BIBLIOGRAPHY
1. Kemenkes RI. Petunjuk Teknis Manajemen dan Tatalaksana TB Anak. Jakarta: Kemenkes RI, 2016.
2. Nastiti NR, Bambang S, dan Darmawan BS. Buku Ajar Respirologi Anak. Edisi ke-1. Badan Penerbit IDAI: Jakarta; 2008.
3. Nastiti NR, Darfioes R, Makmuri MS, Cissy BK. Pedoman Nasional Tuberkulosis Anak. Edisi ke-2. Badan Penerbit IDAI:
Jakarta; 2008.
4. Sudoyo AW dkk. Buku Ajar Ilmu Penyakit Dalam Jilid III. Edisi ke-5. Interna Publishing: Jakarta; 2009. p. 2230-2248.
5. Longo DL, Kasper DL, Jameson JL dkk. Harrison’s Principles of Internal Med78icine. Edisi ke-18. McGraw Hill Company:
USA; 2012.
6. Markum AH. Buku Ajar Ilmu Kesehatan Anak Jilid 1. FKUI: Jakarta ; 2002.
7. WHO. Gender in Tuberculosis research. Geneva: World Health Organization; 2012.
8. Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan Kementerian Kesehatan Republik Indonesia.
Strategi Nasional Pengendalian Tb di Indonesia 2010-2014. Direktorat Jenderal Pengendalian Penyakit dan Penyehatan
Lingkungan Kementerian Kesehatan Republik Indonesia: Jakarta; 2011. p.12
9. Rahajoe N, Basir D, Makmuri MS, Kartasasmita CB. Pedoman Nasional Tuberkulosis Anak. UKK Pulmonologi. Badan
Penerbit IDAI: Jakarta; 2005.
10. Werdhani, Retno Asti. Patofisiologi, Diagnosis, Dan Klafisikasi Tuberkulosis. Departemen Ilmu Kedokteran Komunitas,
Okupasi, Dan Keluarga FKUI. 2002.
11. PDPI. Tuberkulosis Pedoman Diagnosis dan Penatalaksanaan di Indonesia, Jakarta. 2002.
12. Kartasasmita CB. Childhood tuberculosis in the community. Disampaikan pada International paediatric respiratory and
allergy congress. Prague, Czech Republic: 2001
THANK YOU