Holistic management of a 51-year-old male patient with multibacillary hansen's disease through a family doctor approach

Authors

  • Pratiwi Hesti Harmoni Puskesmas Kedungjati, Indonesia
  • Hidayatul Musabakoh Puskesmas Kedungjati, Indonesia

DOI:

https://doi.org/10.35335/midwifery.v14i1.2291

Keywords:

Leprosy, Family Medicine, Holistic Management, Patient-Centered Care, Quality of Life

Abstract

Hansen's disease, or leprosy, is a chronic progressive granulomatous disease caused by Mycobacterium leprae, which primarily affects the skin and peripheral nervous system. This disease remains a public health problem in several regions of Indonesia, including Grobogan Regency. The prevalence rate of leprosy in Grobogan Regency in 2022 was 3 per 100,000 population, and the incidence rate of new cases was 0.7 per 100,000 population. This case report aims to apply the principles of family medicine in the holistic and comprehensive management of leprosy patients, with a patient-centered and family-oriented approach, based on evidence-based medicine. This report uses a case study approach. Primary data were obtained through anamnesis, physical examination, and home visits to evaluate the patient's living environment. The evaluation was conducted comprehensively through a holistic diagnostic approach, covering the initial phase (assessment), the intervention process, and the results. The management of leprosy with a holistic and evidence-based family medicine approach can provide more optimal results, not only in clinical aspects but also in improving the understanding and involvement of patients and their families. This approach supports efforts to prevent disability and improve the overall quality of life of patients.

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References

Ahmad, S., & Katoch, V. M. (2021). Evolution of social wellbeing of leprosy affected people. Indian Journal of Leprosy, 93(4), 379–389.

Batista, T. V. G., Vieira, C. S. C. A., & de Paula, M. A. B. (2014). Body image in educational actions in self-care for people who had leprosy. Physis, 24(1), 89–104. https://doi.org/10.1590/S0103-73312014000100006

Chaptini, C., & Marshman, G. (2015). Leprosy: A review on elimination, reducing the disease burden, and future research. Leprosy Review, 86(4), 307–315.

Darmi, M., Johari, A., Sahrial, S., & Guspianto, G. (2024). Health education method on leprosy prevention: Integrative review. Archives of Razi Institute, 79(1), 1–12. https://doi.org/10.32592/ARI.2024.79.1.1

Dinas Kesehatan Kabupaten Grobogan. (2023). Profil kesehatan Kabupaten Grobogan tahun 2023. Dinas Kesehatan Kabupaten Grobogan.

Dinas Kesehatan Provinsi Jawa Tengah. (2022). Profil kesehatan provinsi Jawa Tengah tahun 2022. Dinas Kesehatan Provinsi Jawa Tengah.

Edelyne Chelsea, L. Y., & Irawan, Y. (2024). Kusta multibasiler dengan reaksi eritema nodosum leprosum: Laporan kasus. eJournal Kedokteran Indonesia, 12(3), 325–330.

Froes Junior, L. A. R., Sotto, M. N., & Trindade, M. A. B. (2023). Leprosy in the 21st century: A comprehensive review of immunological mechanisms, diagnosis, and treatment. Revista do Instituto de Medicina Tropical de São Paulo, 65, e32.

Govindharaj, P., Srinivasan, S., & Darlong, J. (2021). Awareness of leprosy—Knowledge and perception among people affected by leprosy in an endemic district, West Bengal, India. Indian Journal of Leprosy, 93(1), 29–39.

Heidinger, M., Simonnet, E., Karippadathu, F., Puchinger, M., Pfeifer, J., & Grisold, A. (2018). Analysis of social determinants of health and disability scores in leprosy-affected persons in Salem, Tamil Nadu, India. International Journal of Environmental Research and Public Health, 15(12), 2769. https://doi.org/10.3390/ijerph15122769

Kementerian Kesehatan Republik Indonesia. (2023). Pedoman nasional program pengendalian penyakit kusta. Kementerian Kesehatan Republik Indonesia.

Kerr-Pontes, L. R. S., Montenegro, A. C. D., Barreto, M. L., Werneck, G. L., & Feldmeier, H. (2004). Inequality and leprosy in Northeast Brazil: An ecological study. International Journal of Epidemiology, 33(2), 262–269. https://doi.org/10.1093/ije/dyh002

Lukito, A. A., Paralaga, I. B. K. B., & Supradnyan, I. K. H. (2024). The growing threat of antimicrobial resistance in Mycobacterium leprae: A literature review. Intisari Sains Medis, 15(3), 1324–1332.

Marahatta, S. B., Amatya, R., Adhikari, S., Giri, D., Lama, S., Kaehler, N., Rijal, K. R., Marahatta, S., & Adhikari, B. (2018). Perceived stigma of leprosy among community members and health care providers in Lalitpur district of Nepal: A qualitative study. PLoS ONE, 13(12), e0209676. https://doi.org/10.1371/journal.pone.0209676

Marciano, L. H. S. C., Marques, T., Quaggio, C. M. P., & Nardi, S. M. T. (2018). Physical therapy in leprosy. In Dermatology in public health environments: A comprehensive textbook (pp. 1503–1532). https://doi.org/10.1007/978-3-319-33919-1_73

Mukti, B., Ivantirta, I., & Zuraida, R. (2024). Penatalaksanaan holistik pasien dengan Morbus Hansen multibasiler melalui pendekatan dokter keluarga. Jurnal Penelitian Perawat Profesional, 6(5), 1927–1940.

Nardi, S. M. T., Marciano, L. H. S. C., Marques, T., & da Paz Quaggio, C. M. (2023). Physical therapy in leprosy. In Dermatology in public health environments: A comprehensive textbook, second edition (pp. 2009–2041). https://doi.org/10.1007/978-3-031-13505-7_83

Nery, J. S., Ramond, A., Pescarini, J. M., Alves, A., Strina, A., Ichihara, M. Y., Fernandes Penna, M. L., Smeeth, L., Rodrigues, L. C., Barreto, M. L., Brickley, E. B., & Penna, G. O. (2019). Socioeconomic determinants of leprosy new case detection in the 100 Million Brazilian Cohort: A population-based linkage study. The Lancet Global Health, 7(9), e1226–e1236. https://doi.org/10.1016/S2214-109X(19)30260-8

Prakoeswa, F. R. S., Maharani, F., Sari, W. A., & Risanti, E. D. (2025). Overcoming negative stigma towards leprosy patients. Berkala Ilmu Kesehatan Kulit dan Kelamin, 37(1), 59–62. https://doi.org/10.20473/bikk.V37.1.2025.59-62

Pratiwi, S. I., Towidjojo, V. D., Pratika, M., & Agni, F. (2025). Reaksi kusta dan kecacatan derajat II pada pasien Morbus Hansen tipe multibasiler. Journal of Medical Professionals, 7(1), 45–52.

Qian, J., Ma, Y., Wei, Y., Peng, Z., Li, W., Zhang, T., Yin, F., & Shui, T. (2025). Socioeconomic determinants of the leprosy risk in Yunnan Province, China: A county-level spatiotemporal study. Frontiers in Public Health, 13, 1427319. https://doi.org/10.3389/fpubh.2025.1427319

Rahmi, A. M., Listiawan, M. Y., Murtiastutik, D., Hidayati, A. N., Ervianti, E., & Utomo, B. (2024). Multidrug therapy efficacy in multibacillary leprosy patients: A retrospective study. Migration Letters, 21(5), 51–58.

Rao, P. N., & Suneetha, S. (2021). Leprosy—The name and the stigma. Indian Journal of Leprosy, 93(4), 405–413.

Rasolofozafy, H., Ronse, M., Andrianiriana, L. M. J., Andriamira, R., Hasker, E., de Jong, B. C., Cauchoix, B., Ramboarina, S., Gryseels, C., & Grietens, K. P. (2025). Leprosy perceptions and health seeking behaviour in Miandrivazo district, Madagascar. PLoS Neglected Tropical Diseases, 19(11), e0013212. https://doi.org/10.1371/journal.pntd.0013212

Rather, S., Shah, F. Y., Akhtar, S., Devi, R., Hassan, I., & Bhat, Y. J. (2022). Scenario of leprosy and pattern of disability in post-elimination era: A seven year study from a tertiary care hospital of Kashmir Valley. Indian Journal of Leprosy, 94, 49–61.

Sampaio, P. B., Bertolde, A. I., Maciel, E. L., & Zandonade, E. (2013). Correlation between the spatial distribution of leprosy and socioeconomic indicators in the city of Vitória, State of ES, Brazil. Leprosy Review, 84(4), 256–265.

Sserunkuma, M. C., Sembatya, B. B., Moses, K., Mpambaara, C., Sahayarani, A., Fastenau, A., Penna, S., van Brakel, W. H., & Kasang, C. (2024). Participation of people with disabilities due to leprosy, lymphatic filariasis (LF), and other causes in Uganda. Leprosy Review, 95(3), e2023108. https://doi.org/10.47276/lr.95.3.2023108

Tabah, E. N., Nsagha, D. S., Bissek, A.-C. Z.-K., Njamnshi, T. N., Njih, I. N.-N., Pluschke, G., & Njamnshi, A. K. (2018). Community knowledge, perceptions, and attitudes regarding leprosy in rural Cameroon: The case of Ekondotiti and Mbonge health districts in the South-west Region. PLoS Neglected Tropical Diseases, 12(2), e0006233. https://doi.org/10.1371/journal.pntd.0006233

Wagenaar, I., van Muiden, L., Alam, K., Bowers, R., Hossain, M. A., Kispotta, K., & Richardus, J. H. (2015). Diet-related risk factors for leprosy: A case-control study. PLoS Neglected Tropical Diseases, 9(5), e0003766. https://doi.org/10.1371/journal.pntd.0003766

World Health Organization (2021). WHO guidelines for the diagnosis, treatment and prevention of leprosy. Geneva: WHO.

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Published

2026-04-11

How to Cite

Harmoni, P. H. and Musabakoh, H. (2026) “Holistic management of a 51-year-old male patient with multibacillary hansen’s disease through a family doctor approach”, Science Midwifery, 14(1), pp. 122–132. doi: 10.35335/midwifery.v14i1.2291.