DOMESTIC ENVIRONMENT AND SOCIO-ECONOMIC FACTORS OF TUBERCULOSIS IN BANDUNG AND WEST TIMOR TITIK RESPATI GILARSI

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DOMESTIC ENVIRONMENT AND SOCIO-ECONOMIC FACTORS
OF TUBERCULOSIS IN BANDUNG AND WEST TIMORTITIK
RESPATI GILARSI
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ABSTRACTThe study set out
to examine whether there is any relationship
between domestic environmental conditions and the
prevalence of Tuberculosis in two districts in
Indonesia, Bandung District and Timor Tengah
Selatan (TTS) District. The data used to
investigate the relationship between domestic
environmental conditions and the prevalence of TB
was selected from BES
(Benefit Evaluation Study) survey data. BES was
undertaken by Indonesia National Health Institute
Research and Development and Indonesia Central
Bureau of Statistic.
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INTRODUCTIONAs large cities
continue to sprawl, some age-old infectious
diseases still remain as major health problems in
both the developed and developing countries.
Over several decades tuberculosis (TB) appeared
to have been subdued but in the past decades it
has reemerged with renewed intensity. Although
National effort towards the elimination of TB
started long before Independence Day in 1945,
Indonesia hasnt been able to control the
disease. In Indonesia, tuberculosis is still the
number one cause of death from infectious
diseases.
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Several researchers have suggested that poor
living and socio-economic conditions are closely
associated with TB transmission. However, there
are limited studies showing this relationship
between TB and the environment in Indonesia.
Notwithstanding the lack of research data,
observations and anecdotal evidence from the
treatment of patients indicates that the domestic
environment factors play an important role in the
transmission and control of TB. These factors
include the quality of housing, numbers of people
in each house, the effectiveness of ventilation
and the socio-economic status of the
household unit.
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BackgroundTuberculosis (TB) is
still a major global health problem that claims
more than two million lives per year and infects
almost one third of the world population. It
became so frightfully uncontrolled in some
countries that in 1993 the World Health
Organization declared TB to have the status of a
global health emergency. In 1999 it was estimated
that there were 8.4 million new cases, up from
8.0 million in 1997 (WHO, 2001a). Published
research shows that 95 of TB cases occur in
developing countries and 75 to 80 of them are
people in their productive age group of 15-50
years (MOH, 1999 Snider et al., 1994).
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Indonesia is one the countries with the highest
prevalence of TB in the world. It ranks third
highest in the number of TB cases after India
and China (MOH, 2000a). The prevalence for TB
based on a survey in 1993 in 14 provinces was
0.2 - 0.65 (MOH, 2001). In 1995, Indonesian
National Household Health Survey estimated that
TB is the number one cause of death from
infection (National Annual TB Report, 2000).
Tuberculosis cases in Indonesia are currently
still high while in the other two countries it is
declining. If this trend continues, Indonesia
will become the number one country with the most
number of TB cases.
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Figure 2.2.Triangle of Environment,

agent and host
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AimsTo examine whether the relationship between
domestic environmental conditions and the
prevalence of Tuberculosis (TB) in Bandung
District and Timor Tengah Selatan
District.Design of the studyThis study used
data from The Benefit Evaluation Study (BES)
undertaken by Indonesia National Health Institute
Research and Development and Indones
ia Central Bureau of Statistic.
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Figure 3.2 Map of Study area (Source Modified
MOH, 2001)
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ResultTable 1. Overview of TTS and Bandung
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Table 2. Sample Profiles
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The Analysis of selected demographic variables
with TB prevalence.Table 3. Selected Chi squared
results from cross tabulation of TB prevalence
with selected demographic variables.
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Table 4. Risk Estimates of TB prevalence with
selected demographic variables.
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The Analysis of Selected Domestic Environmental
Factors and TB PrevalenceNumber of bedroom and
number of bedroom with window and ventilation,
household density and bedroom with window and
ventilation density were variables analyse to
show type of housing and living conditions. These
were analyzed to determine the relationship
between the variables and the difference between
cases and non cases of TB. The findings are
presented in Table 5.
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Table 5. Selected Chi squared results from cross
tabulation of TB prevalence with selected
domestic environmental factors.
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Table 6. Risk Estimates of TB prevalence with
selected housing variables.