Risk Factors Of Pulmonary Tuberculosis In Teluk Bintuni District, Papua Barat Province

Abstract

Pulmonary Tuberculosis (TB) remains a major public health issue in Indonesia, including in Teluk Bintuni District. The increasing trend of cases highlights the urgency of identifying risk factors, particularly in underserved areas. This study aimed to analyze risk factors associated with pulmonary TB incidence in Teluk Bintuni. A quantitative case-control (1:2) was used, involving 336 respondents selected purposively from patients who sought care between January–December 2024. Cases were confirmed TB patients, and controls were non-TB patients. Secondary data were obtained from the Tuberculosis Information System (SITB) and health center records. Bivariate analysis using chi-square and Fisher’s exact tests identified variables with p<0.25 for inclusion in multivariate logistic regression. Significant associations were found between TB and HIV status, education, distance to health facilities, and ethnicity. HIV positivity was observed in 12.5% of cases versus 3.1% of controls (p=0.001; OR=4.429). Low education was more common among controls (79.5%) than cases (55.4%) (p<0.001;OR=0.320), and non-Papuan ethnicity accounted for 25.0% of cases and 8.5% of controls (p<0.001; OR=0.278). Living ≥5 km from health services was less frequent in cases (14.3%) than controls (24.1%) (p=0.037; OR=0.525). In multivariate analysis, HIV status, ethnicity, and education remained significant, with HIV as the strongest predictor (aOR=4.376; p=0.003). The lower TB prevalence among less-educated individuals may reflect underdiagnosis due to limited access or care-seeking. Findings underscore the need for HIV control, improved detection, and culturally tailored TB strategies in remote communities.