Koefesien Kappa sebagai Indeks Kesepakatan Hasil Diognosis Mikroskopis Malaria di Kabupaten Belu Nusa Tenggara Timur

AbstractBlood slide examination is used as standard malaria diagnosis in Indonesia. Quality assurance for malaria microscopic examination is an important issue in the monitoring and supervision of the administration of antimalarials drugs. This step was done to determine the accuracy of thediagnosis, thus could be used for further evaluation in improving the skills of microscopic health centre personnel. This study aims to determine the accuracy of malaria microscopic examination at Primary health centre and District Health Office personnels in Belu District, Nusa Tenggara Timur.The study was an observational research with cross sectional approach. The competency of primary health center and district healt office microscopist in examining malaria blood smears were evaluated using standard blood smears compared with smears from Passive Case Detection (PCD) activities. Performance in preparing blood smear were evaluatied by observation and filling the checklist. The study was conducted in April - Juni 2012 in Belu District, NTT. Quality assurance was assessed based on the results of cross-checking and assessments of Kappa coefficient between primary health centre and district Health office microscopic personnel and those between district health centers and Department of parasitology, faculty of Medicine, (Gadjah Mada University) certified microscopicpersonnel. Result shows that the strength of agreement between the Primary Health Centre and the District Health Office microscopic personnel centers was "good" (kappa 0.61 to 0.80), while those between District Health Office and Department of Parasitology UGM showed poor agreement (0,20– 0,40)Keywords : microscopic examination of malaria, Belu District, cross check, KappaAbstrakPemeriksaan sediaan darah masih merupakan baku emas penegakan diagnosis malaria di Indonesia. Pemantapan kualitas mikroskopis malaria merupakan hal penting dalam pemantauan dan pengawasan pemberian obat anti malaria yang tepat sasaran. Pemantapan dilakukan untuk mendapatkan ketepatan diagnosis dan sebagai bahan evaluasi dalam upaya perbaikan keterampilan mikroskopis dijarak yang akan datang. Metode penelitian ini adalah observasi dengan pendekatan cross sectional. Penelitian ini bertujuan untuk mengetahui ketepatan pemeriksaan mikroskopis malaria pada tenaga mikroskopis malaria di Kabupaten Belu, Nusa Tenggara Timur. Kemampuan diagnosis malaria petugas mikroskopis Puskesmas dan kabupaten dievaluasi dengan pemberian sediaan darah baku maupun sediaan darah yang didapat dari Passive Case Detection (PCD). Evaluasi kinerja dilakukan dengan pengamatan dan pengisian checklist oleh peneliti. Penelitian dilakukan pada bulan April - Juni 2012 di Kabupaten Belu Propinsi Nusa Tenggara Timur. Pemantauan kualitas dinilai berdasarkan hasil cross check dan penilaian koefisien Kappa antara tenaga mikroskopis Puskesmas dan mikrokopis dinas kesehatan kabupaten dengan mikroskopis parasitologiFakultas Kedokteran Universitas Gadjah Mada (FK UGM) yang tersertifikasi, hasil kesepakatan diagnosis menunjukan kekuatan kesepakatan antara mikroskopis Puskesmas dan mikroskopis dinas kesehatan kabupaten “baik” (Kappa 0,61-0,80) sedangkan Kappa antara kabupaten denganFK UGM nenunjukan “kurang” (0,20-0,40).Kata kunci : pemeriksaan mikrokopis malaria, kabupaten Belu, cross check, Kapp