Holistic Management of an Elderly Patient with Relapsed Pulmonary Tuberculosis and Herpes Zoster Accompanied by Inadequate Housing Conditions in Indonesia Primary Health Centre

Abstract : Pulmonary tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major global health issue, particularly in developing countries. Weakened immunity in TB patients increases their risk of herpes zoster, whose incidence rises with age. Over 60% of cases occur in individuals older than 50 years, while only 10% affect those under 20. This case report highlights the application of evidence-based medicine in family practice, focusing on identifying risk factors, clinical issues, and patient management through a patient-centered, family-oriented approach. Data were collected through anamnesis, physical examinations, and home visits to evaluate family, psychosocial, and environmental factors. Additional information was obtained from the patient’s medical records. A holistic assessment was conducted from diagnosis to outcome, incorporating qualitative and quantitative analyses. The patient, Mr. A., a 72-year-old, presented with relapsed pulmonary TB and herpes zoster. He sought routine anti-tuberculosis drug retrieval and reported lesions on his left back with sensations of heat and itching. Interventions led to improvements in TB symptoms, healing of herpes lesions, and enhanced patient behaviour. Quantitative evaluations showed increased knowledge, medication adherence, and better dietary habits. The diagnosis and management followed national guidelines and relevant literature. Positive outcomes were observed in the patient’s symptoms, knowledge, and behaviours, as well as improvements within his family, as assessed during follow-ups. This case underscores the importance of holistic and evidence-based approaches in addressing complex comorbidities in primary care.