Ecological Factors Influencing Tuberculosis in Indonesia: Exploring the Interplay of Health Resources, Socioeconomic Status, Climatic Factors, and Consumption Patterns

The elimination of tuberculosis (TB) in Indonesia is a challenging task due to its persistent increase in incidence, making it one of the primary infectious diseases that cause death. Until now, its handling has not been optimal. In this study, we take an ecological approach to discussing TB cases that can offer a comprehensive perspective, but only some studies still discuss this approach in Indonesia. This study aims to investigate various ecological factors—health resources, socioeconomic status, climatic factors, and consumption patterns—to provide an understanding of TB cases. We collected data on TB cases and ecological factors in 34 provinces in Indonesia from 2005 to 2020, leading to the development of a study by combining 41 tertiary and four secondary indicators. We compiled a panel dataset using a fixed-effects model to select and assess ecological factors associated with TB cases. This study revealed that those that showed a statistically significant correlation to the increase in TB cases were influenced by the number of TB cases treated, sanitarians, toddler obesity, income inequality, precipitation, rainy days, and temperature. In contrast, nutritionists, health insurance, population, and access to protein sources showed statistically significant correlations to the decline in TB cases. This study provides an overview of various ecological factors that influence TB cases in Indonesia, and the results of this study can be a basis for the government to create evidence-based policies to accelerate the handling of TB cases so that elimination by 2030 can be achieved.