Helina Helmy, Adam Irwansyah Fauzi, Enro Sujiton

Spasial TB. Paru BTA (+) Pada Puskesmas Hc. Kedaton Kecamatan Kedaton Bandar Lampung

Introduction

Spasial tb. Paru bta (+) pada puskesmas hc. Kedaton kecamatan kedaton bandar lampung . Analisis spasial TB.Paru BTA(+) di Kedaton, Bandar Lampung. Meneliti jarak antar-rumah pasien dan risiko transmisi di area padat penduduk. Studi Euclidean distance.

Abstract

Mycobacterium tuberculosis is characterized by a thick, mycolic acid–rich cell wall that confers hydrophobicity, chemical resistance, and environmental stability, making cell wall biosynthesis inhibitors a major therapeutic target. Tuberculosis is not only a medical condition but also a social disease linked to high population density, malnutrition, and limited healthcare access. In 2023, Kedaton District was identified as the most densely populated area in Bandar Lampung, increasing the likelihood of pulmonary TB smear-positive (TB.Paru BTA+) transmission. Aerosol spread is highly distance-dependent: direct exposure within 0–1 meter poses very high risk, and WHO reports indicate that exposure <1 meter for ≥15 minutes in enclosed spaces significantly elevates infection risk, extending up to 5–10 meters without ventilation. This study employed spatial analysis to measure inter-household distances among 75 TB.Paru BTA(+) patients using Euclidean distance and smartphone-based field surveys. The method proved suitable for small-scale studies with high data accuracy, though resource-intensive for larger populations. Findings revealed some households only 3 meters apart, but this observation was not yet statistically significant to confirm transmission dynamics.

Review

This study presents an interesting and highly relevant spatial analysis of smear-positive pulmonary tuberculosis (TB.Paru BTA+) in Kedaton District, Bandar Lampung, an area identified for its high population density and increased risk of TB transmission. The authors appropriately frame TB not just as a medical but also a social disease, necessitating approaches that consider environmental and social determinants. The methodology, employing Euclidean distance measurement and smartphone-based field surveys to assess inter-household distances among 75 patients, demonstrates a practical, small-scale approach to understanding proximity, which is crucial given the aerosol-borne nature of the disease. While the practical approach to data collection is commendable for its accuracy in a limited setting, the abstract highlights a significant limitation: the observation of households being only 3 meters apart was "not yet statistically significant to confirm transmission dynamics." This suggests that the spatial analysis might be largely descriptive at this stage, and deeper statistical inference regarding transmission pathways or clustering patterns is lacking. The study's focus on simple Euclidean distances, while a start, might not fully capture the complexity of aerosol spread, which is influenced by ventilation and prolonged exposure, as rightly pointed out by the authors themselves. Furthermore, for a disease prevalent in a densely populated area, a sample size of 75 patients, while manageable for resource-intensive field surveys, might be insufficient to draw robust conclusions about population-level transmission dynamics or to achieve statistical significance. Despite the current limitations in achieving statistical significance regarding transmission, this study lays important groundwork for further research. The approach of identifying and mapping patient locations and their proximity offers valuable insights for local public health interventions, particularly in resource-constrained settings. Future iterations of this work would greatly benefit from expanding the sample size, incorporating more sophisticated spatial epidemiological techniques (e.g., cluster analysis, hot-spot mapping, or geographically weighted regression) to establish statistical associations, and integrating social and environmental covariates that influence transmission. Such enhancements would strengthen the ability to confirm transmission dynamics and provide actionable data for targeted TB control and prevention strategies in high-risk urban environments.

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