Individual and Environmental Risk Factors of Tuberculosis: A New Evidence from Ponorogo, East Java

Abstract

Background: For centuries, TB has been linked anecdotally with environmental risk factors that go hand-in-hand with poverty: indoor air pollution, tobacco smoke, malnutrition, overcrowded living conditions, and excessive alcohol use. But to date, there is no empirical evidence from East Java, Indonesia, to support these anecdotal evidences. The purpose of this study was to provide new evidence on the individual and environmental risk factors of tuberculosis in Ponorogo, East Java. Subjects and Method: A case control study was conducted in Ponorogo, East Java, from April to May 2018. A sample of 200 study subjects was selected for this study by fixed disease sampling. The dependent variable was tuberculosis. The independent variables were age, gender, education, nutritional status, dwelling density, smoking, and alcohol drinking. Data on tuberculosis infection status were obtained from the medical record at District Health Office Ponorogo. The data were collected by questionnaire and analyzed by a multiple logistic regression on Stata 13. Results: Age ≥ 44 years (b= 3.18; 95% CI= 1.66 to 4.69; p<0.001), nutritional status (b= 1.42; 95% CI= 0.02 to 2.82; p=0.046), dwelling density ≥ 5 (b= 1.87; 95% CI= 0.37 to 3.36; p=0.014), smoking (b= 2.23; 95% CI= 0.61 to 3.85; p=0.007), and alcohol drinking (b= 2.83; 95% CI= 1.38 to 4.27; p<0.001) were associated with increased risk of tuberculosis. Higher education (b=-2.56; 95% CI=-4.16 to-0.96; p=0.002) and female (b=-1.36; 95% CI=-2.92 to-0.20; p=0.087) were associated with decreased risk of tuberculosis. Conclusion: Age, nutritional status, dwelling density, smoking, alcohol drinking, education, and female, are shown in this study to be the risk factors of tuberculosis.