The role of nutritional medical therapy on nutritional status, functional capacity and quality of life of pulmonary tuberculosis patients with difficulty

Main Article Content

Nugrahayu Widyawardani
Yohannessa Wulandari


Pulmonary tuberculosis (pulmonary TB) is a chronic infectious disease with high levels of morbidity and mortality. Metabolic changes due to tuberculosis Mycobacterium infection and activation of the neurohormonal system contribute to the occurrence of malnutrition, which can have a negative effect on the prognosis of patients with pulmonary TB, as well as decreased functional capacity and quality of life. The provision of medical nutrition therapy from the beginning of diagnosis is upheld, supporting the recovery process of TB patients. In this series of cases, there were four cases of Pulmonary TB patients with difficulty, namely TB billion, chronic obstructive pulmonary disease (COPD), and meningitis TB. At the beginning of the examination, there was a deficiency of macronutrients and micronutrients, hypoalbuminemia, anemia, and decreased functional capacity and quality of life. Medical nutrition therapy is administered individually, according to clinical conditions such as TB with mild, moderate and severe malnutrition, those are gradually weight loss and muscle wasting when the symptoms start until treated in intensive care unit (ICU) and hospital ward. According to laboratory parameters such as anemia, hypoalbuminemia, and a history of food intake analysis such as hypocaloric and starvation.


Download data is not yet available.

Article Details

Author Biographies

Nugrahayu Widyawardani, 1. Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital 2. Faculty of Medicine, Universitas Pembangunan Nasional Veteran, Jakarta

1) Department of Nutrition 2) Medical Education Research Center Laboratory, Departement of Nutrition and Physiology

Tjandraningrum, Sumber Waras Hospital, Jakarta

Department of Nutrition

Yohannessa Wulandari, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital

Department of Nutrition


1. World Health Organization. Global Tuberculosis.; 2017.

2. Ministry of Health of the Republic of Indonesia. National guidelines for tuberculosis control. J Public health. 2011:2011.

3. Lai H-H, Lai Y-J, Yen Y-F. Association of Body Mass Index with Timing of Death during Tuberculosis Treatment. Dowdy DW, ed. PLoS One. 2017;12(1)

4. Semba RD, Darnton-Hill I, de Pee S. Addressing tuberculosis in the context of malnutrition and HIV coinfection. Food Nutr Bull. 2010;31(4):S345-64.

5. Sinclair D, Abba K, Grobler L, Sudarsanam TD. Nutritional supplements for people being treated for active tuberculosis. Review:Update of Cochrane Database Syst Rev. 2011;(11).

6. Guideline: Nutritional care and support for patients with tuberculosis. World Heal Organ 2013.

7. Ministry of Health Republik Indonesia. National TB control strategy. 2016-2020. 2016

8. Singer P, Blaser AR, Berger MM, et al. ESPEN guidline on clinical nutrition in the intensive care unit. Clin Nutr 2018.

9. McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the Provision and Assesment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society Of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N). J Parenter Enter Nutr 2016;40(2):159-211

10. Qian F, Korat AA, Malik V, Hu FB. Metabolic Effects of Monounsaturated Fatty Acids-Enriched Diets Compared With Carbohydrate or Polyunsaturated Fatty Acid-Enriched Diets in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Diabetes Care 2016; 39(8): 1448-1457.

11. Junaid K, Rehman A. Impact of vitamin D on infectious disease-tuberculosis-a review.
Clin Nutr Exp. 2019;25:1-10.
12. Grobler L, Nagpal S, Sudarsanam TD, Sinclair D. Nutritional supplements for people being treated for active tuberculosis. Cochrane Database Syst Rev. June 2016.

13. Sathenahali VB, Minarey N, Gornale V, Kumar R, Joshi K, Association of Tuberculosis With Severe Acute Malnutrition. J Evol Med Dent Sci 2015; 4 (68):11865-11870.

14. Amaral EP, Costa DL, Namasivayam S, et al. A major role for ferroptosis in Mycobacterium tuberculosis-induced cell death and tissue necrosis. J Exp Med. 2019; 216 (3): 556-570.

15. Sola E, Rivera C, Mangual M, Martinez J, Rivera K, Fernandez R. Diabetes mellitus: an important risk factor for reactivation of tuberculosis. Endocrinol Diabetes Metab Case Report 2016.

16. Miwa K, Mitsuoka M, Takamori S, Hayashi A, Shirouzu K. Continous Monitoring of Oxygen Consumption in Patients Undergoing Weaning From Mechanical Ventilation. Respiration 2003; 70(6): 623-630.

17. Maggini S, Wintergerst ES, Beveridge S, Horniq DH. Selected Vitamin and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses 2019; (2007):29-35.