Holistic Management in Pulmonary Tuberculosis Patients with Malnutrition


Aila Karyus(1*)

(1) Mitra Indonesia University
(*) Corresponding Author


Background: Tuberculosis (TB) is still a problem in developing countries and even the world. TB is one of the top 10 causes of death and the first cause of death from an infectious agent worldwide. The government plans to eliminate TB by 2030, which is carried out with the National Strategy for TB Control. Family doctors play an important role in which the role of family doctors is not only to cure but also to promote health and prevention of TB disease. Purpose: The application of evidence-based medical doctor family services to patients by identifying risk factors, clinical problems, and management with a patient-centered approach and family approach. Method: The study conducted was a Case Report. Primary data were obtained through history taking and physical examination by making home visits, filling family folders, and filling patient files. The assessment was carried out based on the initial holistic diagnosis, process, and end of the visit quantitatively and qualitatively. Results: Based on a holistic diagnosis, it was found that an 87-year-old patient complained of coughing, difficulty in swallowing, and weight loss since three months ago, three weeks ago the patient was diagnosed with TB. Physical examination showed a BMI of 14.2. The patient had difficulty swallowing, with the examination of nerves 10 within normal limits. Internal risk factors include a lack of knowledge about TB, and aging. External factors are often exposed to dust. Functional degrees 4. Four visits were made. The interventions provided in the form of education about TB include the definition, symptoms, treatment and prevention, counseling with the family, and providing a high-calorie, high-protein diet for patients. The evaluation results show an increase in patient and family knowledge about TB and an improvement in the patient's diet that the family has done. Conclusion: The diagnosis of TB with malnutrition and dysphagia is good. Management provided is in accordance with the guidelines, visible changes in behavior, and knowledge of patients and patients' families after an intervention based on evidence-based medicine that is patient-centered, family approach.


TB; malnutrition; dysphagia

Full Text:



  1. Ministry of Health, Republic of Indonesia. Data and information from the Indonesian Ministry of Health. Tuberculosis. Jakarta: Infodatin, Ministry of Health, Republic of Indonesia; 2018.
  2. World Health Organization. Global tuberculosis report. France: World Health Organization; 2018.
  3. World Health Organisation. Global tuberculosis report 2018 [internet]. c2018. Available from: www.who.int/tb/publications/global_report/en/
  4. Ramadhayanti DA, Cahyo K, Widagdo L. Factors that influence the prevention of tuberculosis drop out in families in all working areas of the Semarang City Health Center. E-Journal Jurnal Kesehatan Masyarakat (Undip). 2018; 6(2):163-9.
  5. Nurmadya N, Medison I, Bachtiar H. The relationship between the implementation of the strategy directly observed short course treatment with the results of pulmonary tuberculosis treatment at Padang Pasir Public Health Center, Padang City 2011-2013. Jurnal Kesehatan Andalas. 2015; 4(1):207–11.
  6. Ministry of Health, Republic of Indonesia. National guidelines for tuberculosis control. Jakarta: Ministry of Health, Republic of Indonesia; 2014.
  7. Ministry of Health, Republic of Indonesia. Health profile data and information 2019. Jakarta: Ministry of Health, Republic of Indonesia; 2020.
  8. Ministry of Health, Republic of Indonesia. Tuberculosis: find treat until cured. Jakarta: Ministry of Health, Republic of Indonesia; 2015.
  9. Novfattra N, Hardisman H, Semiarty R. Analysis of policy implementation on the Nagari movement for tuberculosis in Kenagarian Magek, Kamang Magek District, Agam Regency in 2018. Jurnal Kesehatan Andalas. 2019 May 14; 8(2):331-7.
  10. Ministry of Health, Republic of Indonesia. Tuberculosis control. Regulation of the Minister of Health of the Republic of Indonesia number 67 of 2016. Jakarta: Ministry of Health, Republic of Indonesia; 2016
  11. Indonesian Lung Doctors Association. Guidelines for the diagnosis and management of tuberculosis in Indonesia. Jakarta:Indonesian Lung Doctors Association; 2011.
  12. Yen FY, Chuang PH, Yen MY, Lin SY, Chuang P, Yuan MJ, et al. Association of body mass index with tuberculosis mortality: a population-based follow-up study. Medicine. 2016; 95(1):1-8.
  13. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett-Smith S. Patient-centered care improvement guide. Derby: The Picker Institute; 2008.
  14. Ujainah A. Collaboration management and control of tuberculosis and diabetes mellitus. Jurnal Penyakit Dalam Indonesia. 2015 Mar 31; 2(1):1.
  15. Cahyawati F. TB management in people with HIV/AIDS (ODHA). Cermin Dunia Kedokteran. 2018 Sep 1; 45(9):704-8.
  16. Almatsier S. The new edition of the diet guide, perjan nutrition installation at Dr. Cipto Mangunkusumo Hospital and the Association of Indonesian Dietitian. Jakarta: Gramedia Pustaka Utama; 2008.

DOI: https://doi.org/10.22146/rpcpe.68872

Article Metrics

Abstract views : 243 | views : 86


  • There are currently no refbacks.

Copyright (c) 2024 Aila Karyus

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

View My Stats