Determinant factors that contribute to the increasing tuberculosis prevalence in Rokan Hilir, Indonesia

Tuberculosis (TB) continues to be a severe public health problem at local, national, and global levels. At the local level, the trend of increasing the spread of TB cases in Rokan Hilir District, Indonesia requires the identification of the determinants, so that scenarios for prevention and control can be developed appropriately and effectively. Therefore, this study will identify factors contributing to increase TB incidence at the sub-district level in Rokan Hilir District. This study uses a mixed design (mixed method) consisting of observational studies, case control, and spatial approaches based on Geographic Information Systems (GIS). Observational studies were carried out on track record data of TB sufferers, demographics, and health infrastructure during the ۲۰۱۷-۲۰۲۰ period. The case-control approach was applied to socio-economic and physical environment variables in ۵۳ case respondents and ۶۱ control respondents. A GIS-based spatial method was used to acquire climate variability and perform interpolation, interpretation, and spatial presentation in thematic maps. The findings of TB incidents from ۲۰۱۷ through ۲۰۲۰ experienced an increasing trend of ۱۹.۵۸ % per year with an average number of cases (± SD) of ۱,۰۶۸ ± ۶۰.۹۷ cases/year. TB incidence increased with an expanding population (R ۲ = ۰.۶۷۵), population density (R ۲ = ۰.۶۹۱), number of health workers (R ۲ = ۰.۵۹۷), and number of health facilities (R ۲ = ۰.۵۰۹). The elevated risk of TB disease occurred in people of unproductive age [odds ratio (OR) ۲.۴۰۹, ۹۵% confidence interval (CI) ۱.۱۳۰-۵.۱۳۴], low education (OR ۴.۰۲۷, ۹۹% CI = ۱.۷۷۹-۹.۱۱۵), low income (OR ۳.۶۳۲), type of floor (OR ۲.۴۴۹, ۹۵% CI = ۱.۱۴۴-۵.۲۳۹), wall type (OR ۲.۸۵۱, ۹۹% CI =۱.۳۲۲-۶.۱۴۶), and occupancy density (OR ۳.۹۴۴, ۹۹% CI = ۱.۷۹۹=۸.۶۴۷). Demographic, socio-economic conditions, physical environment, and the availability of health facilities and infrastructure were determinants influencing the incidence of TB. Scenario intervention on determinant factors is the key to successful TB disease control to meet the ۲۰۳۰ national TB disease incidence elimination target.

کلیدواژه ها:

Tuberculosis (TB) ، Determinants ، Spatial distribution ، Indonesia