Health Policy and Analytical Cross-Sectional Study of Tuberculosis Determinants Knowledge Nutrition Housing Density Factors Community

Nurnia Saraun; La Ode Asrianto; Teti Susliyanti; Sarifudin Andi Latif

doi:10.61099/jakespol.v1i2.391

Authors

Nurnia Saraun Department of Nursing, Sekolah Tinggi Ilmu Kesehatan IST Buton, Southeast Sulawesi, Indonesia, Indonesia
La Ode Asrianto Department of Nursing, Sekolah Tinggi Ilmu Kesehatan IST Buton, Southeast Sulawesi, Indonesia, Indonesia https://orcid.org/0009-0000-8521-4048
Teti Susliyanti Department of Nursing, Sekolah Tinggi Ilmu Kesehatan IST Buton, Southeast Sulawesi, Indonesia, Indonesia
Sarifudin Andi Latif Department of Nursing, STIKES Amanah Makassar, South Sulawesi, Indonesia, Indonesia https://orcid.org/0009-0000-8830-5965

DOI:

https://doi.org/10.61099/jakespol.v1i2.391

Keywords:

Health Policy, Nutritional Status, Tuberculosis, Pulmonary, Urban Population Density

Abstract

Introduction: Tuberculosis (TB) remains a major public health concern globally and in Indonesia, with increasing incidence reported in recent years. Multiple determinants, including individual knowledge, nutritional status, and housing density, contribute to TB transmission dynamics. In the context of health policy and community-based prevention, understanding these determinants is essential to inform targeted interventions. This study aimed to analyze the association between knowledge, nutritional status, and housing density with pulmonary tuberculosis incidence in the working area of UPTD Puskesmas Lapandewa, South Buton Regency.

Methods: This study employed an analytical observational design with a cross-sectional approach. The population consisted of 132 suspected TB patients registered in 2025, with a sample of 99 respondents selected using simple random sampling. Data were collected through structured questionnaires and anthropometric measurements. Variables included knowledge, housing density, nutritional status, and TB incidence. Data were analyzed using chi-square tests to assess associations, with a significance level of 0.05. Effect sizes were estimated using Odds Ratios (OR) with 95% Confidence Intervals (CI).

Results: Low knowledge was significantly associated with TB incidence (OR=3.12; 95% CI: 1.45–6.72; p=0.003). High housing density was also significantly related to TB occurrence (OR=2.87; 95% CI: 1.36–6.05; p=0.005). Respondents with poor nutritional status had a higher risk of TB (OR=3.45; 95% CI: 1.68–7.10; p=0.001). These results indicate that behavioral and environmental determinants play a critical role in TB transmission.

Conclusion: Knowledge, housing density, and nutritional status are significant determinants of pulmonary tuberculosis incidence. Strengthening health policies that focus on community education, housing improvements, and nutritional interventions is essential to reducing the TB burden. Integrated public health strategies are recommended to enhance early detection and prevention efforts.

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References

[1] S. S. Abdul-Nabi, V. Al Karaki, A. Khalil, and T. El Zahran, “Climate change and its environmental and health effects from 2015 to 2022: A scoping review,” Heliyon, vol. 11, no. 3, p. e42315, 2025, doi: https://doi.org/10.1016/j.heliyon.2025.e42315.

[2] R. Agustina et al., “Nutrient Intake Adequacy among Adults in Indonesia and Malaysia: A Systematic Review and Meta-Analysis,” Curr. Dev. Nutr., vol. 9, no. 5, p. 106010, 2025, doi: https://doi.org/10.1016/j.cdnut.2025.106010.

[3] H. W. Aung et al., “Heat-related health impacts in ASEAN countries: A scoping review,” Environ. Sustain. Indic., vol. 30, p. 101272, 2026, doi: https://doi.org/10.1016/j.indic.2026.101272.

[4] M. Barros Serafim, R. Almendra, L. Vizeu Barrozo, and P. Santana, “Socioeconomic deprivation and mortality in megacities during the first two decades of the 21st century: A scoping review of area-based studies,” Soc. Sci. Humanit. Open, vol. 13, p. 102406, 2026, doi: https://doi.org/10.1016/j.ssaho.2025.102406.

[5] A. Daiber, S. Rajagopalan, M. Kuntic, and T. Münzel, “Cardiovascular risk posed by the exposome,” Atherosclerosis, vol. 405, p. 119222, 2025, doi: https://doi.org/10.1016/j.atherosclerosis.2025.119222.

[6] R. Haque et al., “A systematic review of the pivotal role of environmental toxicant exposure on infectious diseases in low- and middle-income countries,” Public Heal. Pract., vol. 10, p. 100631, 2025, doi: https://doi.org/10.1016/j.puhip.2025.100631.

[7] T. M. I. Haverkate et al., “Environmental-demographic determinants associated with tuberculosis prevalence in seven African countries: an aggregated dataset analysis,” eClinicalMedicine, vol. 92, p. 103773, 2026, doi: https://doi.org/10.1016/j.eclinm.2026.103773.

[8] M. M. KA et al., “Promotion of Cardiovascular Health in Africa: The Alliance for Medical Research in Africa (AMedRA) Expert Panel,” JACC Adv., vol. 3, no. 12, Part 2, p. 101376, 2024, doi: https://doi.org/10.1016/j.jacadv.2024.101376.

[9] M. K. Kim, J. Bhattacharya, and J. Bhattacharya, “Is income inequality linked to infectious disease prevalence? A hypothesis-generating study using tuberculosis,” Soc. Sci. Med., vol. 345, p. 116639, 2024, doi: https://doi.org/10.1016/j.socscimed.2024.116639.

[10] M. Kameni Nematchoua et al., “Multimorbidity and mortality trends in the COVID19 syndemic in Madagascar covering 180 diseases 2015 2024,” iScience, vol. 29, no. 2, p. 114444, 2026, doi: https://doi.org/10.1016/j.isci.2025.114444.

[11] M. R. Khorshid, S. Behzadi, A. Sharifi, A. Vafaeinejad, Z. Abbasian, and H. Naderi, “Evaluation of spatial and non-spatial factors on tuberculosis using geospatial information system and fuzzy logic,” Spat. Spatiotemporal. Epidemiol., vol. 54, p. 100729, 2025, doi: https://doi.org/10.1016/j.sste.2025.100729.

[12] J. M. Zuniga et al., “IAPAC–Lancet HIV Commission on the future of urban HIV responses,” Lancet HIV, vol. 11, no. 9, pp. e607–e648, 2024, doi: https://doi.org/10.1016/S2352-3018(24)00124-3.

[13] K. Kwon, H. Jeong, H. W. Yim, and M. N. Potenza, “History of suicidality and mortality risk: A nationwide cohort study,” J. Affect. Disord., vol. 393, p. 120448, 2026, doi: https://doi.org/10.1016/j.jad.2025.120448.

[14] B. Vidal, L. Verger, and G. J. Nagy, “Exploring the One Health–One Welfare nexus and zoonoses,” Sci. One Heal., vol. 4, p. 100128, 2025, doi: https://doi.org/10.1016/j.soh.2025.100128.

[15] Y. L. Lew et al., “Treatment outcomes of drug-resistant tuberculosis in Sabah, Malaysia – a retrospective cohort study,” Public Heal. Pract., vol. 9, p. 100616, 2025, doi: https://doi.org/10.1016/j.puhip.2025.100616.

[16] Y. Liao, D. Men, H. Li, Y. Li, and Y. Liu, “Street-level ambient fine particulate matter and tuberculosis: A machine learning and Bayesian spatiotemporal analysis,” Environ. Pollut., vol. 395, p. 127811, 2026, doi: https://doi.org/10.1016/j.envpol.2026.127811.

[17] J. A. Mangela, M. Jusman Rau, A. Arwan, R. Nurul Fadjriah, and N. Wayan Sridani, “Effect of self-efficacy and social support on medication compliance for tuberculosis patients,” J. Ilm. Kesehat. Sandi Husada, vol. 15, no. 1 SE-Articles, pp. 10–19, Apr. 2026, doi: https://doi.org/10.35816/jiksh.v15i1.202.

[18] M. M. Meher, M. Afrin, A. Al Bayazid, M. S. Islam, and M. Z. Ali, “Deciphering the impact of heat wave in the global surge of infectious diseases,” Hyg. Environ. Heal. Adv., vol. 15, p. 100135, 2025, doi: https://doi.org/10.1016/j.heha.2025.100135.

[19] K. G. Mishra, N. Patnaik, B. Harshitha, A. Mohandas, A. Roy, and S. Patnaik, “Food insecurity: A formidable barrier to medication adherence in a vulnerable population with chronic diseases,” Clin. Epidemiol. Glob. Heal., vol. 33, p. 102033, 2025, doi: https://doi.org/10.1016/j.cegh.2025.102033.

[20] X. Peng, X. Chen, R. Zhou, F. Shi, T. Zhu, and G. Chen, “Exploring Risk Factors Related to Low Calf Circumference in Older Adults With Multimorbidity: Cross-Sectional Latent Class Analysis,” JMIR Aging, vol. 8, 2025, doi: https://doi.org/10.2196/68760.

[21] S. Prinja et al., “The state of primary health care in south Asia,” Lancet Glob. Heal., vol. 12, no. 10, pp. e1693–e1705, Oct. 2024, doi: https://doi.org/10.1016/S2214-109X(24)00119-0.

[22] R. Rukmini et al., “Prevalence and socioeconomic determinants of tuberculosis among children in Indonesia: Findings from the 2023 Indonesian health survey,” Indian J. Tuberc., vol. 73, no. 1, pp. 88–92, 2026, doi: https://doi.org/10.1016/j.ijtb.2025.05.001.

[23] H. Salawati, Y. Lu, F. Li, B. Mailiman, Y. Zheng, and L. Zhang, “Gender and diagnostic shifts in TB trends: Insights from 15-year data in Northwest China,” Respir. Med., vol. 257, p. 108856, 2026, doi: https://doi.org/10.1016/j.rmed.2026.108856.

[24] Y. Semenova, L. Lim, Z. Salpynov, A. Gaipov, and M. Jakovljevic, “Historical evolution of healthcare systems of post-soviet Russia, Belarus, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, Armenia, and Azerbaijan: A scoping review,” Heliyon, vol. 10, no. 8, p. e29550, Apr. 2024, doi: https://dx.doi.org/10.1016/j.heliyon.2024.e29550.

[25] U. B. Singh et al., “Lessons and updates from India’s National Tuberculosis Elimination Program – bold decisions and innovative ways of fast-tracking progress toward ending tuberculosis,” IJID Reg., vol. 14, p. 100599, 2025, doi: https://doi.org/10.1016/j.ijregi.2025.100599.

[26] S. A. L. Suprapto Dewi Nurhanifah, Muh Yunus, Lumastari Ajeng Wijayanti, “How is Quality in Homecare Services Created? A Qualitative Study of Health Professional Perspectives,” J. Kesehat. Masy., vol. 21, no. 2, pp. 485–496, 2025, doi: https://dx.doi.org/10.15294/kemas.v21i2.31257.

[27] A. Vargas-Prieto, J. García-Estévez, and J. F. Ariza, “Gold mining and perinatal mortality: New evidence for Colombia,” Environ. Pollut., vol. 390, p. 127451, 2026, doi: https://doi.org/10.1016/j.envpol.2025.127451.