Pulmonary Tuberculosis Suspects and Their Determinants among Boarding Students in Islamic Boarding Schools in the Garut District

Abstract

Living in a crowded Islamic boarding school (pondok pesantren) may cause tuberculosis (TB) transmission, poor sanitation and personal hygiene presenting risks for residents’ health. Sleeping together in a small room may increase the risk of TB transmission in the pondok pesantren. The objective of this study is to assess TB suspects and their determinants among boarding students at Islamic boarding schools in Garut. A cross-sectional design was employed in this study. Applying two stages of cluster sampling, 429 samples were selected from six Islamic boarding schools in the Garut District. Data was collected through interviews, using a questionnaire that was pre-tested for validity and reliability, and analyzed using a multiple logistic regression technique. This study determined that almost 22% of the boarding students, commonly known as santri, had been suffering from a cough for at least 2 weeks (TB suspects). Half of them (50.8%) are women, living in environments prone to TB transmission (62.5%), having low levels of knowledge of TB (70.6%), exhibiting poor TB prevention behavior (52.7%), and around 37% are smokers. The analysis proves that sex and smoking
habits are associated with TB suspects. Smoking habits are the most dominant risk factor for TB suspects after controlling for knowledge of TB. The risk of smoking santris becoming a TB suspect is 2.7 times higher than for those who do not smoke, after controlling for knowledge of TB.



Keywords: tuberculosis, boarding school, boarded students.

References
[1] Balasubramanian, R., Garg, R., Santha, T., Gopi, P. G., Subramani, R., Chandrasekaran, V & Niruparani, C.(2004). Gender disparities in tuberculosis; report from rural DOTS programme in south India.The International Journal of Tuberculosis and Lung Disease, 8(3), 323-332.


[2] Chudlori, M. Y. (2015). Pondok Pesantren DalamPerspektif Kesehatan,. RMI PBNU Jateng. https://rmi-jateng.org/iqro/2405-pondok-pesantren-dalam-prespektifkesehatan, accessed on 20 Aug 2016.


[3] Corbett, E. L., Watt, C. J., Walker, N., Maher, D., Williams, B. G., Raviglione, M. C., & Dye, C.(2003). The growing burden of tuberculosis: global trends and interactions with the HIV epidemic.Archives of Internal Medicine, 163(9), 1009-1021.


[4] Gilson, L., Doherty, J.,Loewenson, R.,& Francis, V. (2007). Knowledge Network on Health Systems; WHO Commission on social determinants of health. Final report. London: Centre for Health Policy.


[5] Harling, G.,Ehrlich, R., & Myer, L.(2008). The social epidemiology of tuberculosis in South Africa: a multilevel analysis. Social Science & Medicine, 66(2), 492-505.


[6] Haryono, I., Prabandari, Y.S. Widodo Hariyono, W. ,(2008). Environmental Health Education through Kultum.Berita Kedokteran Masyarakat, 24(1), 8-15.


[7] Hossain, S., Zaman, K., Quaiyum, A., Banu, S., Husain, A., Islam, A., ... & van Leth, F.(2015). Factors associated with poor knowledge among adults on tuberculosis in Bangladesh: results from a nationwide survey.Journal of Health, Population and Nutrition,34(1), 2.


[8] Kjellstrom, T., Mercado, S., Barten, F., .(2007). Our cities, our health, our future: Acting on Social Determinants or Health Equity in Urban Settings. Report to the WHO Commission on Social Determinants of Health from the Knowledge Network on urban settings. Kobe: World Health Organization Kobe Center.


[9] Lin, H.,Ezzati, M.,& Murray, M. (2007). Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis. PLoS Medicine, 4(1), e142.


[10] Lonnroth, K.,Jaramillo, E., Williams, B. G., Dye, C., & Raviglione, M.(2009). Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Elsevier, Social Science and Medicine, 68(12), 2240-2246.


[11] Ma, M. J., Yang, Y., Wang, H. B., Zhu, Y. F., Fang, L. Q., An, X. P., ... & Zhang, Z. Y.(2015). Transmissibility of tuberculosis among school contacts; an outbreak investigation in a boarding middle school, China. Center for Inference and Dynamics of Infectious Diseases, Infection, Genetic and Evolution, 32, 148-155.


[12] Parker, L. (2008). The Experience of Adolescent Students in Modernist Islamic Boarding Schools in West Sumatra, Indonesia. Asian Studies, M211, School of Social and Cultural Studies. The University of Western Australia.


[13] Prince, M.,Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., & Rahman, A.(2007). No health without mental health. Lancet, 370(590), 859-877.


[14] Rieder, H. (1999). Epidemiologic basis of tuberculosis control. Paris: International Union Against Tuberculosis and Lung Disease.


[15] Stein-Zamir, C., Volovik, I., Rishpon, S., Atamna, A., Lavy, A., &Weiler-Ravell, D.(2006). tuberculosis outbreak among students in a boarding school. European Respiratory Journal, 28(5), 986-991.


[16] The Lodi Tuberculosis Working Group. (1993). A school and community-based outbreak of Mycobacterium tuberculosis in Northern Italy, 1992–3. Epidemiology and Infection, 113, 83-93.


[17] Zuhriy, M. S. (2011). Budaya Pesantren dan Pendidikan Karakter pada Pondok Pesantren Salaf. UIN Sunan Kalijaga Yogyakarta, Jurnal Penelitian Sosial Keagamaan, 19(2), 287-30.