Risk Factors for Pulmonary Tuberculosis in Rural Areas of Tilango Health Center, Gorontalo

The Ministry of Health of the Republic of Indonesia has set a target for pulmonary tuberculosis (TB) elimination by 2030; however, its implementation still faces various challenges in the field. This study aimed to describe the prevalence of pulmonary TB and examine the influence of indoor air quality and a history of diabetes mellitus (DM) on pulmonary TB incidence within the working area of Tilango Health Center, Gorontalo Regency. A case-control study design was employed, with each study group comprising 54 participants. The results showed that Tabumela Village recorded the highest proportion of pulmonary TB cases (31.5%), with most patients being male (55.6%) and aged 45–54 years (25.9%). Environmental factor analysis indicated that natural lighting was significantly associated with pulmonary TB incidence (p = 0.020), whereas humidity, temperature, and household ventilation (p = 0.837; 0.837; 0.558) did not show a significant relationship. A history of BCG immunization and previous COVID-19 infection (p = 0.643; 0.558) were also not significantly associated with pulmonary TB. Conversely, a strong association was observed between DM and pulmonary TB incidence (p < 0.001), indicating that individuals with DM have a higher risk. These findings underscore that pulmonary TB prevention requires improving natural lighting in homes, managing DM, and implementing integrated strategies through housing environment improvements and community education.