Spatial Fuzzy Risk Mapping for Tuberculosis in Surabaya, Indonesia

Abstract

Surabaya, one of the major cities in Indonesia, is an endemic area for spreading tuberculosis. Surabaya City Health Office in 2018 has found 7,007 cases of tuberculosis which is the highest case in East Java province. This data shows that TB is still a major health problem. TB risk mapping is needed to guide the Public Health Service in TB control planning, for example, the promotion of clean and healthy living behaviors, immunizations, and home visit programs and optimization of TB screening activities. This paper proposes the spatial risk mapping of tuberculosis based on several criteria that become tuberculosis risk factors using a fuzzy method called spatial fuzzy risk mapping. These criteria consist of the number of people with tuberculosis (BTA Positive), population density, unhealthy houses, and health facilities. Fuzzy multi-criteria decision making determines the weight value of each criterion, followed by the ranking process to select the best alternative from the sub-district areas. After fuzzy membership calculation, the sub-district areas area directly classified into 3 index level that is low, medium, and high according to the rule association. The determination of the TB disease risk index covers 31 sub-districts in Surabaya as densely populated urban areas. The risk map is visualized into spatial GIS mapping. In the last 3 years (2013-2015), there were 4 sub-districts are decreasing (12.9%), 6 sub-districts are increasing (19.4%) and the remaining 68.7% did not change. There are 13.33% sub-districts in 2015 that are defined as low risk by the fuzzy risk, but it must be high risk by the Public Health Service. The fuzzy risk index results appropriate with the real condition and it is suitable with the Public Health Service report.