Factors Influencing Pulmonary Tuberculosis Incidence in Banggai Laut

Background: Tuberculosis (TB) remains a global health priority, especially in developing countries. The increasing incidence, compounded by drug-resistant strains, poses significant public health challenges. In Indonesia, the TB burden is evident in Central Sulawesi, particularly in Banggai Laut Regency, where low detection rates and geographic barriers complicate control efforts. This study aims to analyze the spatial distribution of pulmonary TB in Banggai Laut Regency from 2021 to 2023, contributing to evidence-based public health strategies in maritime regions. Methods: A quantitative ecological study was conducted, analyzing 399 pulmonary TB cases registered from 2021 to 2023. The study incorporated demographic and geographic variables, including gender, population density, elevation, healthcare access, and housing conditions. Data were collected from TB registers and regional reports, and spatial analysis was performed using GIS tools to map TB distribution. Statistical analysis, including univariate, bivariate, and correlation analysis, was conducted using STATA and QGIS software. Results: The study found that TB incidence was higher in males and varied by age group, with the highest incidence recorded in 2022. Significant negative correlations were identified between TB incidence and healthcare workers, and positive correlations with the distance to healthcare facilities. Spatial analysis revealed that TB cases were concentrated in subdistricts with lower population density, fewer healthcare workers, and greater distance from healthcare services. Geographic factors, such as elevation and male-to-female sex ratio, also influenced TB distribution. Conclusion: The findings underscore the critical role of healthcare accessibility, workforce availability, and geographic factors in TB control. Interventions to improve healthcare services, increase healthcare worker density, and enhance housing conditions are essential to reduce TB incidence in remote regions. Spatial and environmental factors should guide future TB control strategies in maritime areas.