Environmental Risk Factors and Spatial Distribution of Pulmonary Tuberculosis in Tanjung Morawa, Indonesia

Desy Ari Apsari, Deli Syaputri, Samuel Marganda H Manalu, Susanti Br Perangin-angin

Abstract


Pulmonary tuberculosis remains a major public health issue, particularly in regions with poor living conditions that facilitate transmission. Understanding the interplay between environmental risk factors and spatial distribution is essential for designing effective interventions. This study examined environmental determinants and spatial clustering of pulmonary tuberculosis cases within the Tanjung Morawa Health Center area, Deli Serdang Regency, Indonesia. Using an observational analytic case-control design, 160 respondents (80 cases and 80 controls) were selected through simple random sampling. Environmental data, including ventilation, humidity, lighting, residential density, floor condition, and wall condition, were collected through systematic observation and direct measurement. Statistical analyses employed Chi-square tests and multiple logistic regression, whilespatial analysis utilized Geographic Information System (GIS) methods, including Average Nearest Neighbor, overlay, and buffer analyses. Results revealed that household humidity was the strongest predictor of pulmonary tuberculosis (OR=44.33), followed by inadequate lighting and poor floor conditions. Ventilation, wall quality, and residential density showed no significant associations. Spatial analysis demonstrated a clustered distribution pattern, indicating localized transmission in high-risk areas. These findings highlight the critical role of housing quality in tuberculosis transmission.  Targeted interventions focusing on humidity control, housing improvements, and environmental health promotion are recommended to reduce disease burden in identified clusters

 

Keywords: Tuberculosis, Spatial Distribution Pattern, Environmental Risk Factors, Housing Quality

Full Text:

PDF

References


Ayomi, A. C., Setiani, O., & Joko, T. (2012). Faktor Risiko Lingkungan Fisik Rumah dan Karakteristik Wilayah Sebagai Determinan Kejadian Penyakit Tuberkulosis Paru di Wilayah Kerja Puskesmas Sentani Kabupaten Jayapura Provinsi Papua. Urnal Kesehatan Lingkungan Indonesia, 11(1), 1–8. https://doi.org/10.14710/jkli.11.1.1-8

Dinas Kesehatan Kabupaten Deli Serdang. (2024). Profil Kesehatan Kabupaten Deli Serdang 2024. Kabupaten Deli Serdang : Dinas Kesehatan Kabupaten Deli Serdang. https://dinkes.deliserdangkab.go.id/wp-content/filewebsite/5a99c8804083b632547cd2d4df62b7ef.pdf

Fahdhienie, F., Mudatsir, M., Abidin, T. F., & Nurjannah, N. (2024). Risk factors of pulmonary tuberculosis in Indonesia : A case-control study in a high. Narra Journal, 6(4), 1–12. https://doi.org/10.52225/narra.v4i2.943

Gifari, R. M., Azmina, A., & Zubir, A. (2024). The role of environmental factors on disease and trans- mission of infectious diseases. Environmental and Toxicology Management, 4(3), 11–16.

Gordis, L. (2014). Epidemiology. Philadelphia: Elsevier Saunders.

Harahap, K., Sinaga, B. Y. M., Syarani, F., & Eyanoer, P. C. (2025). Factors Associated with the Incidence of Pulmonary Tuberculosis in Patients with Type 2 Diabetes Mellitus. Mutiara Medika: Jurnal Kedokteran Dan Kesehatan, 25(2), 123–131. https://doi.org/10.18196/mmjkk.v25i2.27405

Hartina, S., Asrifuddin, A., & Kandou, G. D. (2019). Analisis Faktor Risiko Kejadian TB Paru Di Wilayah Kerja Puskesmas Girian Weru Kota Bitung. Jurnal Kesmas, 8(6), 65–73. https://ejournal.unsrat.ac.id/index.php/kesmas/article/view/25405

Hasnita, N., Ichwansyah, F., Abdurrahman, F. bin, Usman, S., & Zahara, M. (2025). Analysis of Risk Factors for Pulmonary Tuberculosis Incidence. Indonesian Journal of Global Health Research, 7(2), 219–234. https://doi.org/10.37287/ijghr.v7i2.5553

Irawan, I., Satrina, & Marniati. (2025). Analysis of Pulmonary Tuberculosis Incidence in Productive Age and Family Role in its Management : Literature Review. International Journal of Psychology and Health Science, 3(3), 333–348. https://doi.org/10.38035/ijphs.v3i3.1068

Kemenkes RI. (2021). Profil Kesehatan Indonesia Tahun 2021. In Profil Kesehatan Indonesia Tahun 2021.

Mauliyana, A., & Hadrikaselma, E. (2021). Risk Factors of Pulmonary Tuberculosis in the Working Area of Perumnas Public Health Center Kendari City. Miracle Journal of Public Health, 4(2), 202–213. https://doi.org/10.36566/mjph/Vol4.Iss2/257

Oktavia, S., Hidayati, F., Lesmana, O., & Butar, M. B. (2025). Hubungan Kondisi Fisik Lingkungan Rumah dengan Kejadian Tuberkulosis Paru di Indonesia ( Analisis Data Survei Kesehatan Indonesia Tahun 2023 ). Journal of Artificial Intelligence and Digital Business (RIGGS), 4(4), 3581–3588. https://doi.org/10.31004/riggs.v4i4.4109

Pangaribuan, L., Kristina, K., Perwitasari, D., Tejayanti, T., & Lolong, D. B. (2020). Faktor-Faktor yang Mempengaruhi Kejadian Tuberkulosis pada Umur 15 Tahun ke Atas di Indonesia. Buletin Penelitian Sistem Kesehatan, 23(1), 10–17. https://doi.org/10.22435/hsr.v23i1.2594

Pratama, D. P., Julyani, S., Rasfayanah, R., Nasruddin, H., & Anggita, D. (2024). Hubungan Lingkungan Fisik Rumah Dan Perilaku Kesehatan Terhadap Kejadian TB Paru di Wilayah Kec. Mamasa, Sulawesi Barat. Jurnal Kesehatan Tambusai, 5(1), 1697–1709. https://doi.org/10.31004/jkt.v5i1.26055

Rusnoto, Nasriyah, Meitasari, P., & Nisa, A. Z. (2020). The Relationship Between Education and Economic Status on Pulmonary Tuberculosis. Proceedings of the 5th Universitas Ahmad Dahlan Public Health Conference (UPHEC 2019). https://doi.org/10.2991/ahsr.k.200311.030

Sa’adah, N., Prasetyowati, I., & Bumi, C. (2022). Hubungan Riwayat Kontak dengan Pasien Tuberkulosis Paru pada Kejadian TB-DM di Wilayah Kerja Puskesmas Kalisat. Media Kesehatan Masyarakat Indonesia, 21(3), 184–189. https://doi.org/10.14710/mkmi.21.3.184-189

Salsabilah, K. S., & Afriansya, R. (2024). Hubungan Lingkungan, Pendidikan, Dan Ekonomi MasyarakatTerhadap Kejadian TBParu Di Kedungmundu Kota Semarang. Borneo Journal of Medical Laboratory Technology, 6(2), 621–627. https://doi.org/10.33084/bjmlt.v6i2.7103

Septiani, M., & Mita, Z. (2020). Hubungan pengetahuan ibu dan dukungan keluarga dengan cakupan pemberian imunisasi dasar di Desa Sangso Kecamatan Samalanga Kabupaten Bireuen. Journal of Healthcare Technology and Medicine, 6(2), 911–922. https://doi.org/10.33143/jhtm.v6i2.1071

Sunarmi, S., & Kurniawaty, K. (2022). Hubungan Karakteristik Pasien TB Paru Dengan Kejadian Tuberkulosis. Jurnal Aisyiyah Medika, 7(2). https://doi.org/10.36729/jam.v7i2.865

Susilawaty, A., Basri, S., Haerana, B. T., Ane, R. La, & Mappau, Z. (2024). The Risk Factors Contributing to The Occurrence of Pulmonary Tuberculosis in The Small Island of South Sulawesi , Indonesia. Public Health of Indonesia, 10(4), 104–116. https://doi.org/10.36685/phi.v10i4.876

WHO. (2020). Global Tuberculosis Report 2020. Ganeva : World Health Organization.

World Health Organization. (2022). Global Tuberculosis Report 2022. https://www.who.int/indonesia/news/campaign/tb-day-2022/fact-sheets

Yang, H., Ruan, X., Li, W., Xiong, J., & Zheng, Y. (2024). Global , regional , and national burden of tuberculosis and attributable risk factors for 204 countries and territories , 1990 – 2021 : a systematic analysis for the Global Burden of Diseases 2021 study. BMC Public Health, 11(24), 1–16. https://doi.org/10.1186/s12889-024-20664-w




DOI: http://dx.doi.org/10.30829/contagion.v8i1.26118

Refbacks

  • There are currently no refbacks.


Copyright (c) 2026 Desy Ari Apsari, Deli Syaputri, Samuel Marganda H Manalu, Susanti Br Perangin-angin

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Contagion: Scientific Periodical Journal of Public Health and Coastal Health by Program Studi Ilmu Kesehatan Masyarakat is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.