Living Conditions and Respiratory Health: A Study on ARI Determinants in a Wetland Urban Settlement in South Sumatra

Abstract

Introduction: Acute respiratory infection (ARI) remains a significant public health concern in Indonesia, particularly among populations living in substandard housing conditions. In South Sumatra Province, ARI cases have shown a sharp increase over recent years, with 32,336 cases reported in 2021, 519,167 cases in 2022, and 539,327 cases in 2023. Urban wetland settlements, such as Ilir Timur II Subdistrict in Palembang City, are especially vulnerable due to poor environmental and socioeconomic conditions. This study aimed to analyze the association between physical housing conditions and household behaviors with the incidence of ARI in a wetland urban settlement. Methods: A cross-sectional study was conducted in 2024 involving 100 residents of Ilir Timur II, Palembang, selected through purposive sampling. Data were collected using structured interviews and analyzed using bivariate tests (Chi-square) and multivariate logistic regression. Results: A total of 66% of households reported at least one ARI case in the past six months. Among the variables examined, only the presence of a ceiling (plafon) was significantly associated with ARI incidence (p = 0.038; OR = 2.60; 95% CI: 1.05–6.41). Other variables such as education level, housing density, roofing, walls, floor condition, smoking behavior, and physical activity showed no significant association. Disscussion: Poor indoor environmental conditions—especially the absence of a ceiling—are associated with an increased risk of ARI in wetland settlements. Improving housing structures and promoting healthy living environments in such areas are essential strategies to reduce the burden of respiratory infections.