Factors Associated with Tuberculosis Incidence from an Environmental Health Perspective: A Case-Control Study in Yogyakarta, Indonesia
https://doi.org/10.53770/medica.v8i10.1141
Keywords
Attitude Behavior Environmental Health Housing Ventilation TuberculosisAbstract
Tuberculosis (TB) remains a major public health problem in Indonesia, and the number of recorded cases in the Mantrijeron Primary Health Center area has continued to increase. This study aimed to analyze the associations of sociodemographic, behavioral, and housing environmental factors with TB incidence. A case-control study was conducted among 64 respondents (32 cases and 32 controls) matched for age, sex, and residential area. Data were collected through structured interviews and observation of housing conditions and were analyzed using the Chi-square test and binary logistic regression, with all eight study variables (gender, education, income, knowledge, attitude, behavior, ventilation, and housing density) entered simultaneously. In the bivariate analysis, TB incidence was significantly associated with knowledge (p = 0.023), attitude (p = 0.022), behavior (p = 0.012), ventilation (p = 0.006), and housing density (p = 0.018), but not with gender, education, or income. The multivariate model was significant as a whole (p = 0.046; Nagelkerke R² = 0.291); however, no variable remained independently significant after mutual adjustment. Inadequate ventilation showed the largest adjusted odds ratio (AOR = 3.616; 95% CI: 0.651–20.074; p = 0.142) and was the least attenuated after adjustment. These findings suggest that behavioral and housing environmental factors contribute jointly to TB occurrence, with ventilation being the most prominent factor. Improvements in housing conditions and TB-related health education are recommended, and larger studies are needed to confirm these associations.
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References
Afrianto, I. (2024). Environmental and behavioral determinants of tuberculosis: A narrative review. Jurnal Riset Kualitatif dan Promosi Kesehatan, 3(1), 26–40. https://doi.org/10.61194/jrkpk.v3i1.673
Agustian, M. D., Masria, S., & Ismawati, I. (2022). Hubungan usia, jenis kelamin dan tingkat pendidikan dengan kejadian TB paru di wilayah kerja Puskesmas Cibadak Kabupaten Sukabumi. Bandung Conference Series: Medical Science, 2(1), 1120–1125.
Apriliani, N. A., Rahayu, U., & Narwati. (2020). Hubungan kondisi fisik rumah dengan kejadian penyakit TBC paru di wilayah kerja Puskesmas Simomulyo Kota Surabaya tahun 2019. Gema Lingkungan Kesehatan, 18(1), 33–38. https://doi.org/10.36568/kesling.v18i1.1103
Armaita, A., Marni, L., Nisa, S., Lucintarillova, B., & Aprihatin, Y. (2024). The relationship of the level of community knowledge in the family environment with tuberculosis prevention efforts. Jurnal Penelitian Pendidikan IPA, 10(2), 714–719. https://doi.org/10.29303/jppipa.v10i2.6856
Bai, W., & Ameyaw, E. K. (2024). Global, regional and national trends in tuberculosis incidence and main risk factors: A study using data from 2000 to 2021. BMC Public Health, 24, 12. https://doi.org/10.1186/s12889-023-17495-6
Darmawansyah, D., & Wulandari, W. (2021). Hubungan tingkat pengetahuan dengan kejadian TB paru di wilayah kerja Puskesmas Padang Serai Kota Bengkulu. Journal of Nursing and Public Health, 9(2), 18–22. https://doi.org/10.37676/jnph.v9i2.1790
Deol, A. K., Scarponi, D., Beckwith, P. G., Yates, T. A., Karat, A. S., Yan, A. W. C., Baisley, K., Grant, A. D., White, R. G., & McCreesh, N. (2021). Estimating ventilation rates in rooms with varying occupancy levels: Relevance for reducing transmission risk of airborne pathogens. PLoS ONE, 16(6), e0253096. https://doi.org/10.1371/journal.pone.0253096
Dinas Kesehatan Kota Yogyakarta. (2023). Tuberkulosis atau TB masih menjadi masalah kesehatan di Kota Yogyakarta. https://kesehatan.jogjakota.go.id/berita/id/450/tuberkulosis-atau-tb-masih-menjadi-masalah-kesehatan-di-kota-yogyakarta/
Effendi, S. U., Khairani, N., & Izhar. (2020). Hubungan kepadatan hunian dan ventilasi rumah dengan kejadian TB paru pada pasien dewasa yang berkunjung ke Puskesmas Karang Jaya Kabupaten Musi Rawas Utara. CHMK Health Journal, 4(2), 140–148.
Fadhilah, A. H., Nurmaladewi, & Saktiansyah, L. O. A. (2023). Pengaruh lingkungan fisik rumah dan perilaku terhadap kejadian tuberkulosis paru BTA positif: Sebuah studi kasus kontrol. Jurnal Ilmu Kesehatan Masyarakat, 19(1), 38–47. https://doi.org/10.19184/ikesma.v19i1.30255
Fahdhienie, F., Agustina, A., & Ramadhana, P. V. (2020). Analisis faktor risiko terhadap kejadian penyakit tuberkulosis di wilayah kerja Puskesmas Pidie Kabupaten Pidie tahun 2019. Sel Jurnal Penelitian Kesehatan, 7(2), 52–60. https://doi.org/10.22435/sel.v7i2.3735
Ginting, D., & Fentiana, N. (2023). Hubungan pengetahuan, sikap dan dukungan keluarga dengan risiko penularan TB paru. Jurnal Ilmu Kesehatan dan Gizi (JIG), 1(4), 88–93.
Irawati, I. (2020). Hubungan kepadatan hunian dan sosial ekonomi dengan kejadian penyakit TB paru di Kelurahan Pecung (wilayah kerja Puskesmas Belakang Padang) Kecamatan Belakang Padang Kota Batam tahun 2019. Dinamika Lingkungan Indonesia, 7(1), 8–12. https://doi.org/10.31258/dli.7.1.p.8-12
Kemenkes RI. (2022). Profil Kesehatan Indonesia 2021. Kementerian Kesehatan Republik Indonesia.
Kilale, A. M., Pantoja, A., Jani, B., Range, N., Ngowi, B. J., Makasi, C., Majaha, M., Manga, C. D., Haule, S., Wilfred, A., Hilary, P., Mahamba, V., Nkiligi, E., Muhandiki, W., Matechi, E., Mutayoba, B., Nishikiori, N., & Ershova, J. (2022). Economic burden of tuberculosis in Tanzania: A national survey of costs faced by tuberculosis-affected households. BMC Public Health, 22, 600. https://doi.org/10.1186/s12889-022-12987-3
Konde, C. P., Asrifuddin, A., & Langi, F. L. F. G. (2020). Hubungan antara umur, status gizi dan kepadatan hunian dengan tuberkulosis paru di Puskesmas Tuminting Kota Manado. Jurnal Kesmas, 9(1), 106–113.
Lee, J.Y., Kwon, N., Goo, G.Y., & Cho, S.I. (2022). Inadequate housing and pulmonary tuberculosis: A systematic review. BMC Public Health, 22, 622. https://doi.org/10.1186/s12889-022-12879-6
Lin, H., Lin, Y., Xiao, L., Chen, Y., Zeng, X., & Chang, C. (2021). How do smoking status and smoking cessation efforts affect TB recurrence after successful completion of anti-TB treatment? A multicenter, prospective cohort study with a 7-year follow-up in China. Nicotine & Tobacco Research, 23(12), 1995–2002. https://doi.org/10.1093/ntr/ntab117
Loh, S. Y., Zakaria, R., & Mohamad, N. (2023). Knowledge, attitude, and stigma on tuberculosis and the associated factors for attitude among tuberculosis contacts in Malaysia. Medeniyet Medical Journal, 38(1), 45–53. https://doi.org/10.4274/MMJ.galenos.2023.14478
Makgopa, S., & Madiba, S. (2021). Tuberculosis knowledge and delayed health care seeking among new diagnosed tuberculosis patients in primary health facilities in an urban district, South Africa. Health Services Insights, 14, 11786329211054035. https://doi.org/10.1177/11786329211054035
Mathofani, P. E., & Febriyanti, R. (2020). Faktor-faktor yang berhubungan dengan kejadian penyakit tuberkulosis (TB) paru di wilayah kerja Puskesmas Serang Kota tahun 2019. Jurnal Ilmiah Kesehatan Masyarakat: Media Komunikasi Komunitas Kesehatan Masyarakat, 12(1), 1–10. https://doi.org/10.52022/jikm.v12i1.53
Muñoz, V., Ayala, A., Vargas, C., Vivanco, E., Elorrieta, F., & Maddaleno, M. (2024). Tuberculosis profile in Chile: Effect of migration, overcrowding and income on tuberculosis and its spatial distribution. Revista Médica de Chile, 152(7), 748–758. https://doi.org/10.4067/s0034-98872024000700748
Nuraini, N., Suhartono, S., & Raharjo, M. (2022). Hubungan faktor lingkungan fisik dalam rumah dan perilaku kesehatan dengan kejadian TB paru di Purwokerto Selatan Banyumas. Jurnal Kesehatan Lingkungan Indonesia, 21(2), 210–218. https://doi.org/10.14710/jkli.21.2.210-218
Portnoy, A., Yamanaka, T., Nguhiu, P., Nishikiori, N., Baena, G., Floyd, K., & Menzies, N. A. (2023). Costs incurred by people receiving tuberculosis treatment in low-income and middle-income countries: A meta-regression analysis. The Lancet Global Health, 11(10), e1640–e1647. https://doi.org/10.1016/S2214-109X(23)00369-8
Pratiwi, A. I. R. D., & Sudiadnyana, I. W. (2021). Hubungan perilaku dan kualitas fisik rumah dengan kejadian TBC paru di wilayah kerja Puskesmas Kediri 1 tahun 2020. Jurnal Kesehatan Lingkungan (JKL), 11(1), 13–17. https://doi.org/10.33992/jkl.v11i1.1403
Puskesmas Mantrijeron. (2023). Profil Puskesmas Mantrijeron 2023. Puskesmas Mantrijeron.
Rini, W. N. E., Halim, R., & Ritonga, A. B. (2023). Hubungan karakteristik individu dan kondisi fisik rumah dengan kejadian tuberkulosis paru. Gema Wiralodra, 14(1), 82–95. https://doi.org/10.31943/gw.v14i1.338
Rokhmalia, F., Khambali, & Rachmaniyah. (2025). Assistance in the prevention of TBC transmission with the application of appropriate technology using cyclone ventilator modification (CVM) in the houses of pulmonary TB and ISPA patients as well as PHBS activities in Wonokusumo District. Frontiers in Community Service and Empowerment, 4(2), 250–259. https://doi.org/10.35882/ficse.v4i2.84
Sulrieni, I. N., Dewi, A., & Masdalena, M. (2023). Hubungan kondisi lingkungan fisik rumah dan perilaku dengan kejadian TB paru di wilayah kerja Puskesmas IV Koto Kinali Kabupaten Pasaman Barat. Behavioral Science Journal, 1(1), 59–69.
Wang, L., Xu, C., Hu, M., Qiao, J., Chen, W., Li, T., Qian, S., & Yan, M. (2021). Spatio-temporal variation in tuberculosis incidence and risk factors for the disease in a region of unbalanced socio-economic development. BMC Public Health, 21, 1817. https://doi.org/10.1186/s12889-021-11833-2
Wang, Y., Gan, Y., Zhang, J., Mei, J., Feng, J., Lu, Z., Shen, X., Zhao, M., Guo, Y., & Yuan, Q. (2021). Analysis of the current status and associated factors of tuberculosis knowledge, attitudes, and practices among elderly people in Shenzhen: A cross-sectional study. BMC Public Health, 21, 1163. https://doi.org/10.1186/s12889-021-11240-7
Widiati, B., & Majdi, M. (2021). Analisis faktor umur, tingkat pendidikan, pekerjaan dan tuberkulosis paru di wilayah kerja Puskesmas Korleko, Kabupaten Lombok Timur. Jurnal Sanitasi dan Lingkungan, 2(2), 173–184.
World Health Organization. (2023). Global tuberculosis report 2023. World Health Organization. https://www.who.int/publications/i/item/9789240083851
Zuraidah, A., & Ali, H. (2020). Hubungan faktor lingkungan rumah terhadap kejadian TB paru BTA positif di wilayah Puskesmas Nusa Indah Kota Bengkulu. Journal of Nursing and Public Health, 8(1), 1–10. https://doi.org/10.37676/jnph.v8i1.1004
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