Environmental Factors Influencing Tuberculosis Incidence in Urban Communities

Abstract

Tuberculosis (TB) remains a pressing public health issue in densely populated urban areas, where environmental conditions can exacerbate transmission risks. This ecological study explored the relationship between environmental factors and TB incidence across six sub-districts in Bandung, Indonesia. Data on TB incidence were obtained from public health centers and cross-referenced with environmental data including housing density, ventilation quality, sunlight exposure, and proximity to industrial zones. Field surveys and household observations were conducted in 240 randomly selected homes. The analysis revealed a strong association between TB incidence and inadequate ventilation, with households having fewer than two windows per room being 2.4 times more likely to report TB cases. Overcrowding (defined as more than 3 persons per room) and indoor air pollution from biomass cooking fuels also showed significant correlations. In contrast, neighborhoods with better waste management and access to green spaces reported fewer TB cases. The study highlights the multifaceted role of environmental determinants in TB control and advocates for an integrated approach that includes urban planning, housing improvements, and environmental health promotion to reduce TB burden in urban Indonesia.