Holistic Management of Tuberculosis in 49 Years Old Woman with Complex Problems through A Family Medicine Approach : Case Report

Authors

  • Aulia Nissa Dewantari Universitas Ahmad Dahlan
  • Dewi Yuniasih Universitas Ahmad Dahlan
  • Tira Alfiani Laariya Universitas Ahmad Dahlan
  • Hega Fitri Nuraga Puskesmas Sanden, Bantul, Yogyakarta, Indonesia
  • Ade Puspa Sari Puskesmas Sanden, Bantul, Yogyakarta, Indonesia

DOI:

https://doi.org/10.12928/admj.v6i1.12893

Keywords:

Tuberculosis , Holistic management , Family medicine approach

Abstract

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, transmitted through airborne droplets when an infected person coughs, sneezes, or talks. Environmental conditions, such as poor ventilation and lack of sunlight, can facilitate the persistence of TB bacteria indoors. Sunlight and good air circulation play key roles in reducing bacterial survival. Health cadres are vital in detecting and managing TB cases in their communities. The Sanden Community Health Center runs a TB prevention and control program (P2TB) to help reduce TB incidence. A 49-year-old woman presented with a persistent cough for approximately two months, accompanied by fatigue, significant weight loss, and decreased appetite. The cough was intermittent, sometimes with phlegm, and unresponsive to cough medication. About a month prior, a Rapid Molecular Test (TCM) at a lung hospital in Yogyakarta confirmed TB. She had a history of unhealthy sexual behavior and was previously diagnosed with syphilis but tested negative for HIV. The patient also has metabolic syndrome. On physical examination, she appeared mildly ill but alert (E4M6V5), with a respiratory rate of 16/min. Lung and skin examinations were normal. Abdominal circumference was 112 cm. The patient received education on TB recognition, prevention, and intervention. Interventions were tailored to be patient-centered, family focused, and community-oriented. She was classified as a bacteriologically confirmed TB case, with no previous history of TB treatment and a negative HIV result..

References

WHO. Global tubercolosis report 2018 [Internet]. Vol. 63, World Health Organization. 2018. 476 p. Available from: https://apps.who.int/iris/handle/10665/274453

Cantres-Fonseca, O. J., Rodriguez-Cintron, W., Olmo-Arroyo, F. D. & BaezCorujo, S., 2019. Extra Pulmonary Tuberculosis: An Overview. In: Role of Microbes in Human Health and Diseases. s.l.:IntechOpen, pp. 1-16.

Aja N, Ramli R, Rahman H. Penularan Tuberkulosis Paru dalam Anggota Keluarga di Wilayah Kerja Puskesmas Siko Kota Ternate. J Kedokt dan Kesehat. ;18(1):78. Published online 2022.

Kementrian Kesehatan Republik Indonesia. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Tuberkulosis. Duke Law J. 2019;1(1):1–139.

Kementrian Kesehatan Republik Indonesia. Dashboard data Kondisi TBC di Indonesia. 2024. Available from: https://tbindonesia.or.id/pustaka-tbc/dashboard/

Kementrian Kesehatan Republik Indonesia. Penyelenggaraan 5th Indonesia Tuberkulosis International Research Meeting (INA – TIME) di Yogyakarta. 2022.

Kemenkes Republik Indonesia. Strategi Nasional Penanggulangan Tuberkulosis 2020-2024. 2020.

World Health Organization. The Dual Epidemic of TB and Diabetes. 2016. Available online: https://www.who.int/tb/publications/diabetes_tb.pdf

Rabbani, N. Z., Susilowati, O., Yuniasih, D., Fitriana, F., Laariya, T. A., Suyatmi, S., & Rahmawati, N. F. Prevalensi Kejadian TB Paru di Wilayah Kerja Puskesmas Sanden Tahun 2020-2022: Relationship of Parenting Pattern And Parental Attitude With Acute Respiratory Infections In Children Under 5 Years. Ahmad Dahlan Medical Journal, 4(1), 78-85. Published online 2023.

Rabahi MF, Silva Júnior JLRD, Ferreira ACG, Tannus-Silva DGS, Conde MB. Tuberculosis treatment. J Bras Pneumol. 2017 Nov-Dec;43(6):472-486. doi: 10.1590/S1806-37562016000000388. Erratum in: J Bras Pneumol. 2018 Jul-Sep;44(4):340. doi: 10.1590/S1806 37562016000000388errata. PMID: 29340497; PMCID: PMC5792048.

Saidi SS, Abdul Manaf R. Effectiveness of family support health education intervention to improve health-related quality of life among pulmonary tuberculosis patients in Melaka, Malaysia. BMC Pulm Med. 2023 Apr 25;23(1):139. doi: 10.1186/s12890-023-02440-5. PMID: 37098515; PMCID: PMC10131462.

Burke, Rachael M., et al. Community-based active case-finding interventions for tuberculosis: a systematic review. The Lancet Public Health, 2021, 6.5: e283-e299.

Athiyah Amatillah, D., Hidayati, A. N., Alinda, M. D., Reza, N. R., Widia, Y., Nurasifah, D., ... & Rahmadhani, S. D. Secondary syphilis with tuberculosis co-infection: A rare case. Published online 2024

Mercadal, T. M. Theories of Health Behavior. 2021. Available https://www.ebsco.com/research-starters/consumer-health/theories-health-behavior. on : Cited 2025 May 7.

Faradillah, S., Thohari, I., & Darjati, D. Kondisi Fisik Rumah, Perilaku Keluarga dan Kejadian TB Paru di Wilayah Kerja Puskesmas Bangkalan. Jurnal Penelitian Kesehatan" SUARA FORIKES"(Journal of Health Research" Forikes Voice"), 13(3), 856-860. Published online 2022.

Craciun, O. M., Torres, M. D. R., Llanes, A. B., & Romay-Barja, M. Tuberculosis Knowledge, Attitudes, and Practice in Middle-and Low-Income Countries: A Systematic Review. Journal of tropical Medicine, 2023(1), 1014666. Published online 2023.

KHATTAK, Mahnoor, et al. Tuberculosis (TB) treatment challenges in TB-diabetes comorbid patients: a systematic review and meta-analysis. Annals of medicine, 2024, 56.1: 2313683.

Girishbhai Patel D, Baral T, Jacob Kurian S, Malakapogu P, Saravu K, Sekhar Miraj S. Nutritional status in patients with tuberculosis and diabetes mellitus: A comparative observational study. J Clin Tuberc Other Mycobact Dis. 2024 Mar 12;35:100428. doi: 10.1016/j.jctube.2024.100428. PMID: 38549700; PMCID: PMC10973140.

Nugroho, Muhammad Nurhazim; ERI, Rifqi Rizkani. 81. The Intersection of Tuberculosis Treatment and Blood Pressure Control: Insights from Primary Healthcare-A Case Report. Journal of Hypertension, 2024, 42.Suppl 2: e21.

Charchar FJ, et al. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. J Hypertens. 2024 Jan 1;42(1):23-49. doi: 10.1097/HJH.0000000000003563. Epub 2023 Sep 12. PMID: 37712135; PMCID: https://www.ncbi.nlm.nih.gov/pmc

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Published

2025-05-18

How to Cite

Dewantari, A. N., Yuniasih, D. ., Alfiani Laariya, T., Nuraga, H. F. ., & Puspa Sari , A. . (2025). Holistic Management of Tuberculosis in 49 Years Old Woman with Complex Problems through A Family Medicine Approach : Case Report. Ahmad Dahlan Medical Journal, 6(1), 80–93. https://doi.org/10.12928/admj.v6i1.12893

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