Spatial Analysis of Pneumonia Distribution in Children Under Five in West Java: Relationships with Individual and Environmental Determinants IN PRESS
Abstract
Pneumonia remains a leading cause of mortality among children under five, particularly in developing nations, with Indonesia experiencing a high prevalence. In West Java, 18,000 pneumonia cases were recorded in 2023, making it one of the provinces with the highest disease burden. Individual determinants such as immunization coverage, exclusive breastfeeding, and low birth weight (LBW), alongside environmental factors including tobacco smoking prevalence, population density, housing conditions, and wood fuel usage, may influence the spatial distribution of cases. This study examines the spatial patterns of pneumonia in children under five in West Java and its association with individual and environmental determinants using Moran’s Index. An ecological analysis was conducted across 27 districts/cities in West Java using data from the Indonesia Health Survey (SKI), Statistics Indonesia (BPS), and the West Java Health Office. Spatial autocorrelation and cluster analyses were performed using GeoDa software. The results indicate that tobacco smoking prevalence (Moran’s I = 0.5573), population density (Moran’s I = 0.258), and wood fuel usage (Moran’s I = 0.4095) significantly correlate with pneumonia cases, forming risk clusters. Conversely, immunization coverage, exclusive breastfeeding, and housing conditions did not show significant spatial associations. These findings highlight the need for targeted public health interventions to address environmental determinants contributing to pneumonia risk.
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