PHYSICAL HOME ENVIRONMENT AS A DETERMINANT OF PULMONARY TUBERKULOSIS RISK: A CASE-CONTROL STUDY

Abstract

Pulmonary tuberculosis (TB) remains a major global public health challenge, particularly in low- and middle-income countries. The physical home environment plays an important role in TB transmission because inadequate housing conditions facilitate the airborne spread of Mycobacterium tuberculosis. Among environmental factors, inadequate ventilation area and high occupancy density have consistently been identified as important determinants of TB transmission.

This study aimed to analyze the association between ventilation area, occupancy density, and the risk of pulmonary tuberculosis.

An observational analytic study with a case-control design was conducted at Banjarejo Primary Health Center, Madiun City, Indonesia. The study involved 46 respondents, including 23 pulmonary TB cases and 23 controls selected using a case-control approach. Data on ventilation area and occupancy density were collected through direct household observation and standardized measurements. Statistical analysis was performed using the Chi-square test, and the strength of association was estimated using Odds Ratio (OR) with 95% confidence intervals (CI)

Ventilation area was significantly associated with pulmonary TB (p = 0.038). Respondents living in houses with inadequate ventilation had a 3.556 fold higher risk of developing pulmonary TB than those living in houses with adequate ventilation (OR = 3.556; 95% CI: 1.049-12.052). Occupancy density was also significantly associated with pulmonary TB (p = 0.008).

Inadequate ventilation area and high occupancy density were significant determinants of pulmonary tuberculosis. Improving household ventilation and reducing overcrowding should be prioritized to support community-based TB prevention and reduce disease transmission, particularly in high-burden settings