Structured Equation Model of Tuberculosis Incidence Based on Its Social Determinants and Risk Factors in Bandar Lampung, Indonesia

World Health Organization through tuberculosis (TB) control averted up to six million deaths and cured thirty-six million people in 1995-2008, but had less success in reducing TB incidence, especially in thirteen high burden countries, including Indonesia. Therefore, TB control will need to have more emphasis on the issues of social determinants, as social determinants affect TB’s incidence directly and/-or through TB’s risk factors. This study aimed to identify a significant effect of social determinants and the risk factors of TB incidence. The research setting was at twenty-seven primary health centers and one hospital that have implemented the Directly Observed Treatment Short Course (DOTS) strategy in Bandar Lampung municipality, Indonesia. Respondents of this research were 238 smear-positive TB patients as case group and 238 patients without TB as control group. Research variables consisted of “social determinants”, “housing condition”, “household food security” and “health access” which were set as latent variables and measured through their indicators. Data had been collected by using questionnaire and then was analyzed with Structural Equation Modeling using SmartPLS 2.0 software. The result showed that “social determinants” through “housing condition” and “household food security” affected “TB incidence”. Moreover, “social determinants”, “housing condition” and “household food security” can be used to explain 34.1% variation of “TB incidence”. In conclusion, the knowledge can be used to support the TB control program, particularly to implement the DOTS strategy together with improving social determinants, housing condition and household food security.