English Summary
THE CINICAL VALUE OF ELISA
MACKO TEST IN PULMONARY TU-
BERCULOSIS
Indro Handoyo, Anik Widijanti
Dept. of Clinical Phahology, Airlangga
University, Surabaya Indonesia
Dept. of Clinical Pathology, SyaifulAnwar
General Hospital, Malang, Indonesia
This clinical study was carried
out on 59 new cases (aged 15
years) of bacteriologically con-
firmed (positive acid fast bacilli)
pulmonary tuberculosis (35 of
which showed positive sputum
culture and PAP-TB test while the
remaining 24 showed only posi-
tive PAP-TB test), 34 healthy para-
medical personnel in the tuber-
culosis ward and 36 patients with
other non-TB diseases attending
the TB Centre in Malang or other
treatment centres.
The aim of the study was to
assess the clinical value of the
macro ELISA method for TB in
pulmonary tuberculosis.
The concentration of specific
IgG against M. tuberculosis of the
sera of the above mentioned
patients and paramedical per-
sonnel was determined by the
macro and the micro ELISA
method of Karjito using the cyto-
plasm of ultrasonicated M. tuber-
culosis var bovis BCG as the anti-
gen.
The result obtained in this study
have shown that the macro ELISA
test for TB had a significantly (p <
0,005) higher degree of diagnos-
tic sensitivity (84,75%), an almost
equal degree (p > 0,05) of speci-
ficity (83,33%) and significantly
(p <0,005) higher degree of diag-
nostic efficiency (84,21%) than the
respective characteristics of the
micro ELISA test for TB (sensitivity
59,32%, specificity 86,21% and
efficiency 69A7%). The positive
predictive value of the macro
ELISA test for TB (89,28%) did not
differ significantly from the posi-
tive predictive value of micro
ELISA test for TB (87,5%) but the
negative predictive value of the
macro ELISA test for TB (76,9%)
was obviously higher than the
ones (56,36%) of the micro ELISA
test for TB.
Based on the results of data
analysis and the discussion in this
study, it can be concluded that
the macro ELISA test for TB is a
reliable test for the diagnosis of
pulmonary TB. However, in pa-
tients with leprosy of the L type
and patients with positive rheu-
matoid factor, the results of the
test should be interpreted care-
fully.
Cermin Dunia Kedokt. 1993; 88: 458
Ih, Aw
PATTERN OF PAYMENT OF HOS-
PITAL BILLS IN RSUD PAMEKASAN
IN Dana Susadi
Department of Internal Medicine, Pa-
mekasan Regional Hospital, Pamekasan,
Indonesia
Payment of hospital bills are
generally taken care of by a
Government Insurance Agency,
a private insurance company,
the company where the patient
is employed or by the patient
himself if he is not covered by
health insurance.
A survey at the General Hos-
pital (RSUD) Pamekasan showed
that the majority (903 out of 1098
patients - 82,24%) of the patients
paid their own bills. This group
(self-paying group) is considered
to be a financially high risk group
in causing bad debt. Hospital
bills for the rest of the patients
were paid by the Government
Insurance (18 patients - 17,03%)
and by their employers (8 pa-
tients - 0,72%).
No explanation could be pro-
posed as to the higher average
of hospitalization period of
patients under government
insurance (7,17 days) compared
to patients paying for them-
selves (4,33 days) and those paid
for by their employers (4,1 days).
Cermin Dunia Kedokt. 1993; 88: 579
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