Risk Factors, Distribution Patterns, and Their Implications for Environmentally Based Tuberculosis Transmission Risk Control Strategies.

Tuberculosis (TB) remains one of the most burdensome infectious diseases in Indonesia. One contributing factor is the environment, particularly issues related to household ventilation and lighting. TB control efforts do not solely rely on medical interventions but also require a community-based approach that emphasizes active community involvement in preventing and controlling environmental risks to TB transmission. This study aims to analyze risk factors, distribution patterns, and their implications for environmentally based TB transmission risk control strategies. A mixed-methods design was conducted in two stages: first, risk factor analysis (with a case-control approach) and disease distribution pattern determination on environmental variables were performed, followed by a multidimensional scaling model (by using the Rapid Appraisal for Fisheries (RAPFISH) method) according to sustainability dimensions (ecological, economic, social, institutional, and technological) based on the resulting significant variables/indicators. This research was conducted in 2024, in four villages/nagari in West Sumatra of Indonesia. For quantitative analysis, data were collected through interviews, physical measurements of the environment, and determination of the coordinates of the residences of people with TB. Data were analyzed using bivariate and multivariate analyses. For the distribution pattern, Nearest Neighbor Analysis (NNA) in the ArcView program version 3.1 was used. Meanwhile, for qualitative data collection, focus group discussion (FGD) was performed. This study found that poor ventilation, minimal lighting, and a lack of stigma competency significantly increased the risk of TB transmission. Varied distribution patterns between regions demand adaptive and locally based strategies. The community-triggering approach is key to building community awareness and participation in creating a healthy and TB-free home environment.