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The population of Indonesia is continually
increasing. In addition the population spread is
becoming more uneven, mainly because of the
urbanization that is becoming more rampant every
year. This rapid growth rate will automatically
increase the community's needs for shelter or
housing. With people’s increasing levels of need for
housing, this will increase the procurement of
housing in Indonesia, primarily in urban areas. This
has led to an increase in social problems and resulted
in a slum housing environment that does not meet
health requirements. Surabaya, which is also a
metropolitan city with rapid development and
becoming a common urbanization destination, is a
target of arising social problems. Problems arising
from the needs of the community needs to be
handled by the government immediately, including
the procurement of housing for the middle to lower
economic level of the community. According to the
United Nations Conference regarding the Problem of
the Human Environment (1972), more than 1 billion
people live below standard conditions and it is likely
that the situation will get worse in the future (WHO
SEARO, 1986; WHO Commission on Health and
Environment, 2001). The housing situation is a
factor that determines the condition of hygiene and
environmental sanitation. Overcrowding and narrow
housing results in high incidences of illness,
accidents, and other issues (Sukarni, 1995).
Based on the Household Health Survey (SKRT)
conducted in 1995 (DG PPM and PL, 2002), the 3rd
leading cause of death in Indonesia is tuberculosis.
Tuberculosis, commonly referred to as TB, is closely
related to unhealthy house sanitation conditions.
Meanwhile, according to the WHO report (2007) on
Global Tuberculosis Control Surveillance, Planning,
and Financing stated that Indonesia was ranked fifth
with the highest number of tuberculosis patients in
Southeast Asia after Bangladesh, Bhutan, DPR
Korea, and India.
WHO also reports that 10 to 20 million people
with tuberculosis in the world can transmit
tuberculosis. Because of pulmonary tuberculosis, the
mortality rate is around 3 million patients each year.
This situation is increasing and almost 75% are
found in low-socio-economic developing countries
(Alsagaaf, 2008).
The Annual Risk of Tuberculosis Infection
(ARTI) including the risk of transmission of
tuberculosis infection in Indonesia, is considered
quite high and varies between 1% and 3%. Areas
with an ARTI, numbers of 1% suggest that every
year, of 1,000 residents, ten will be infected. From
the infected people, only 10% will become
tuberculosis patients. Thus, it can be estimated that,
in an area with an ARTI of 1%, among 100,000
residents there will be 100 tuberculosis patients on
average per year, 50 of which will be positive acid-
fast bacilli (MOH, 2002).
In Indonesia, tuberculosis disease is still
developing. This is related to the deterioration of the
socio-economic conditions of society, public health
service facilities that are not yet optimal, the number
of people, which is continually increasing, many of
whom do not have permanent residence. The
development of the disease is not separate from
human behavior; mainly the behavior of the
inhabitants in the house (Sukarni, 1995).
Based on the Pamekasan district health office
report in 2011, there were as many as 759 people
suffering from tuberculosis during 2010. In
Pamekasan, from 2011 to May 2018, there were 610
residents who are known to suffer from tuberculosis.
The number of tuberculosis patients is mostly
incrasing in three districts: District Palengaan,
Pasean, and District Palengaan. The number of TB
patients in the Pamekasan District is high in East
Java, and the government are trying to implement
treatment. The government said, Pamekasan District
was ranked fifth in East Java regarding cases of TB,
after Sumenep, Lumajang, Malang, and Jember.
According to the latest data from the health services
for 2012 and 2013, there are three Community
Health Centre that successfully identified TB during
2012. Palengaan Health Community Center
identified 111 patients, the Pasean Health
Community Centre identified 96 patients, and there
were 68 patients identified by the Waru Community
Health Center. For the first quarter of 2013, 22
patients came from Pasean, 19 from Palengaan, and
17 from Batumarmar Community Health Center.
It takes six months of treatment to cure the
infectious disease. If within that six months of
treatment, one day is missed, the treatment must
then start all over again. Drugs are provided free of
charge at every health service center under the
health agency. A house that becomes a home and
shelter for its inhabitants, can guarantee their health.
A house assessed as having healthy conditions has
become a determining requirement for the health
status of its inhabitants. Components of a house and
its environment that do not meet health requirements
are risk factors and a source of transmission of
various types of diseases, especially environmental
diseases (Keman, 2005). Unhealthy housing
conditions will have a negative impact on human
health; one impacting result is tuberculosis. Efforts
to control risk factors that influence the occurrence
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