FAKTOR RISIKO DAN SEBARAN TUBERKULOSIS BTA POSITIF

DI KOTA KENDARI PROPINSI SULAWESI TENGGARA TAHUN 2009:

GAMBARAN EPIDEMIOLOGI SPASIAL
RISK FACTORS AND EXTENT OF POSITIVE ACID FAST
BACILLUS LUNG TUBERCULOSIS (PAFBLTB)
AT KENDARI MUNICIPALITY PROVINCE OF SULAWESI TENGGARA 2009:
OVERVIEW OF SPATIAL EPIDEMIOLOGY
Agung Nugroho1, Iswanto2, Anis Fuad3
ABSTRACT
Background: The result of TB prevalence survey in Indonesia 2004 showed that prevalence rate of
PAFBLTB at Sulawesi Tenggara was 210 per 100,000 population. Coverage of case detection rate
(CDR) of PAFBLTB tends to decrease. In 2008 CDR of Kendari municipality was only 42.8%. Low
achievement of CDR raises worries with the existence of TB patients undetected by health staff and
not well medicated according to TB medication guideline. This will bring risk for infection to healthy
people.
Objective: To identify area and factors associated with extent of PAFBLTB disease at Kendari
Municiaplity.
Method: This was a case control study. Cases were patients of PAFBLTB and control were those non
PAFBLTB patients visiting health center. There were 332 samples comprising 161 cases and 161
control. Research instruments consisted of structured questionnaire and geographic positioning
system. Data analysis used 3 approaches, i.e. individual by individual analysis; spatial by observing
extent related to population density, poverty, topography and buffer outreach of health operational unit;
and diffusion analysis to identify pattern of case extent motion.
Result: Variables associated with the prevalence of PAFBLTB were smoking, occupancy density, and
distance to health service. The strongest variable was occupancy density with the score of sig 0.001,
Exp =2.417, 95%CI 1.439-4.058. The result of spatial analysis showed there was association
between overlay of head of poor families and number of PAFBLTB cases (coefficient 0.0048,
probability 0.025). There was cluster in radius 0-1 km from health service unit and radius 0-200 m from
the road. Grouping of lung TB at coordinate 40 00' 47.5 south horizontal and 1220 33' 33.6 east
vertical at radius 1,451.27 m, 30 56' 36.3 south horizontal and 1220 30' 37.2 east vertical at radius
1.076.3 m, 30 57' 58.2 south horizontal and 122 0 32' 42.2 east vertical at radius 2,021.52 m. Diffusion
analysis followed contagious diffusion.
Conclusion: The result of bivariate analysis showed there was association between variables of
occupancy density, social economic status, smoking and service outreach and the prevalence of
PAFBLTB. The result of multivariate analysis showed that variable having the strongest association
was occupancy density. The result of spatial analysis showed there was association between poverty
and the prevalence of PAFBLTB. There were 3 clusters of PAFBLTB and diffusion pattern followed
contagious diffusion.
Keywords: tuberculosis, individual analysis, spatial analysis, diffusion
1.

Health Office, Province of Jawa Timur

Council of Lung Disease Prevention and Medication, Yogyakarta
3.
Graduate Program in Health Management Information System, Gadjah Mada University
2.