The Environmental Factors and Sociodemographic Characteristics of Pneumonia Incidence in Indonesia

Asep Hermawan(1*)
(1) Pusat Riset Kesehatan Masyarakat dan Gizi, BRIN
(*) Corresponding Author
DOI : 10.30604/jika.v7i4.1329


Pneumonia is the leading cause of death in children worldwide, including in Indonesia. Various factors can be considered individually or all at once to determine the incidence of pneumonia. This paper aims to investigate environmental and sociodemographic factors that affect the incidence of pneumonia in Indonesia using data from the 2018 Basic Health Research (Riskesdas). The study design was cross-sectional, using Riskesdas 2018 as data sources with individual analysis units. The research sample was 91,894 respondents with a population of children under five from all over Indonesia. The data were analyzed using multiple logistic regression with an alpha of 5%. This study found that regional (Nusatenggara) AOR 2.1 (95% CI AOR 1.76-2.5), housewife education (primary education) 1.92 (95% CI AOR 1.34-2.76), age group of the children (24-59 months) AOR 1.61 (95% CI AOR 1.35-1.92), and the lack of ventilation in primary bedroom AOR 1.18 (95% CI AOR 1.01-1.36), after controlling for expenditure per capita. Children under five years old are more likely to get pneumonia due to variables that behavioral modifications and health promotion can avoid. Examining the variations in sociodemographic variables and particular places can help with the best interventions.


Abstrak: Pneumonia adalah penyebab utama kematian pada anak di seluruh dunia, termasuk di Indonesia. Berbagai faktor dapat dipertimbangkan secara individual atau kolektif untuk menentukan kejadian pneumonia. Tulisan ini bertujuan untuk menganalisis faktor lingkungan dan sosio-demografi yang mempengaruhi kejadian pneumonia di Indonesia dengan menggunakan data dari Riset Kesehatan Dasar (Riskesdas) 2018. Desain studi adalah potong lintang dengan menggunakan sumber data Riskesdas 2018 dengan unit analisis individu. Sampel penelitian sebanyak 91.894 responden dengan populasi adalah anak balita dari seluruh Indonesia. Data dianalisis menggunakan regresi logistik berganda dengan alpha sebesar 5%. Penelitian ini menemukan bahwa regional (Nusatenggara) AOR 2,1 (95% CI AOR 1,76-2,5), pendidikan ibu rumah tangga (pendidikan dasar) 1,92 (95% CI AOR 1,34-2,76), kelompok usia anak-anak (24-59 bulan) AOR 1,61 (95% CI AOR 1,35-1,92), dan kurangnya ventilasi di kamar tidur utama AOR 1,18 (95% CI AOR 1,01-1,36) adalah factor yang berpengaruh terhadap kejadian pneumonia, setelah mengendalikan pengeluaran per kapita. Anak-anak di bawah lima tahun lebih mungkin terkena pneumonia karena variabel yang dapat dihindari oleh modifikasi perilaku dan promosi kesehatan. Pemahaman variasi dalam variabel sosiodemografi dan wilayah tertentu dapat membantu dengan intervensi yang lebih tepat.


pneumonia; under five of age; toddler; home environment; sociodemographic


Abebo, T. (2016). Prevalence of pneumonia and Associated factors among under five children. Current Pediatric Research, 21.

Adaji, E. E., Ekezie, W., Clifford, M., & Phalkey, R. (2019). Understanding the effect of indoor air pollution on pneumonia in children under 5 in low-and middle-income countries: a systematic review of evidence. Environmental Science and Pollution Research, 26(4), 3208–3225.

Amouzou, A., Velez, L. C., Tarekegn, H., & Young, M. (2016). One is too many: ending child deaths from pneumonia and diarrhoea. The United Nations for Children’s Fund.

Anwar, A., & Dharmayanti, I. (2014). Pneumonia among children under five years of age in Indonesia. Jurnal Kesehatan Masyarakat Nasional, 8(8), 359–365.

Awol, S. M., Wabe, Y. A., & Ali, M. M. (2022). Determinants of pneumonia among children attending public health facilities in Worabe town. Scientific Reports, 12(1), 1–9.

Badan Penelitian dan Pengembangan Kesehatan. (2008). Laporan Nasional Riset Kesehatan Dasar (Riskesdas) 2007.

Badan Penelitian dan Pengembangan Kesehatan. (2013). Laporan Hasil Riset Kesehatan Dasar (RISKESDAS) 2013. Kementerian Kesehatan RI.

Badan Penelitian dan Pengembangan Kesehatan. (2019). Laporan Hasil Riskesdas 2018. Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan.

Badan Penelitian Dan Pengembangan Kesehatan. (2019). Laporan Riset Fasilitas Kesehatan (Rifaskes) 2019: Puskesmas. Kementerian Kesehatan RI.

Ballard, O., & Morrow, A. L. (2013). Human milk composition: nutrients and bioactive factors. Pediatric Clinics of North America, 60(1), 49–74.

Bruce, N. G., Dherani, M. K., Das, J. K., Balakrishnan, K., Adair-Rohani, H., Bhutta, Z. A., & Pope, D. (2013). Control of household air pollution for child survival: estimates for intervention impacts. BMC Public Health, 13(3), 1–13.

Buchner, H., & Rehfuess, E. A. (2015). Cooking and season as risk factors for acute lower respiratory infections in African children: a cross-sectional multi-country analysis. Plos One, 10(6), e0128933.

Cowell, A. (2006). The Relationship Between Education and Health Behavior: Some Empirical Evidence. Health Economics, 15, 125–146.

Dadi, A. F., Kebede, Y., & Birhanu, Z. (2014). Determinants of pneumonia in children aged two months to five years in urban areas of Oromia Zone, Amhara Region, Ethiopia. Open Access Library Journal, 1(08), 1.

Fitriyah, E. N. (2019). Hubungan usia, jenis kelamin, status imunisasi dan gizi dengan kejadian pneumonia pada baduta. Jurnal Biometrika Dan Kependudukan, 8(1), 42–51.

Fotheringham, A., Brunsdon, C., & Charlton, M. (2002). Geographically Weighted Regression: The Analysis of Spatially Varying Relationships. John Wiley & Sons, 13.

Gereige, R. S., & Laufer, P. M. (2013). Pneumonia. Pediatrics in Review, 34(10), 438–456.

Gritly, S. M. O., Elamin, M. O., Rahimtullah, H., Ali, A. Y. H., Dhiblaw, A., Mohamed, E. A., & Adetunji, H. A. (2018). Risk factors of pneumonia among children under 5 years at a pediatric hospital in Sudan. International Journal of Medical Research & Health Sciences, 7(4), 60–68.

Ichikawa, M., Sugita, M., Takahashi, M., Satomi, M., Takeshita, T., Araki, T., & Takahashi, H. (2003). Breast milk macrophages spontaneously produce granulocyte–macrophage colony?stimulating factor and differentiate into dendritic cells in the presence of exogenous interleukin?4 alone. Immunology, 108(2), 189–195.

Indumathi, S., Dhanasekaran, M., Rajkumar, J. S., & Sudarsanam, D. (2013). Exploring the stem cell and non-stem cell constituents of human breast milk. Cytotechnology, 65(3), 385–393.

Karki, S., Fitzpatrick, A. L., & Shrestha, S. (2014). Risk factors for pneumonia in children under 5 years in a teaching hospital in Nepal. Kathmandu University Medical Journal, 12(4), 247–252.

Landsbergis, P. A., Schnall, P. L., Deitz, D. K., Warren, K., Pickering, T. G., & Schwartz, J. E. (1998). Job strain and health behaviors: results of a prospective study. American Journal of Health Promotion, 12(4), 237–245.

Mathew, J. L., Singhi, S., Ray, P., Hagel, E., Saghafian–Hedengren, S., Bansal, A., Ygberg, S., Sodhi, K. S., Kumar, B. V. R., & Nilsson, A. (2015). Etiology of community acquired pneumonia among children in India: prospective, cohort study. Journal of Global Health, 5(2).

McAllister, D. A., Liu, L., Shi, T., Chu, Y., Reed, C., Burrows, J., Adeloye, D., Rudan, I., Black, R. E., & Campbell, H. (2019). Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis. The Lancet Global Health, 7(1), e47–e57.

Nguyen, T. K. P., Tran, T. H., Roberts, C. L., Graham, S. M., & Marais, B. J. (2017). Child pneumonia–focus on the Western Pacific Region. Paediatric Respiratory Reviews, 21, 102–110.

Nirmolia, N., Mahanta, T. G., Boruah, M., Rasaily, R., Kotoky, R. P., & Bora, R. (2018). Prevalence and risk factors of pneumonia in under five children living in slums of Dibrugarh town. Clinical Epidemiology and Global Health, 6(1), 1–4.

Oyejide, C. D. (1988). Review of epidemiological risk factors affecting the pathogenesis of acute respiratory infections. Niger J Paediatr, 15, 1–9.

Raghupathi, V., & Raghupathi, W. (2020). The influence of education on health: An empirical assessment of OECD countries for the period 1995–2015. Archives of Public Health, 78(1), 1–18.

Rahmiza, M., Suhartono, & Nurjazuli. (2018). The Relationships Between Physical Environmental Conditions of House with Pneumonia Incidence on Children Under Five Years, in the Working Area of Ngesrep Health Centre, Semarang City. KnE Life Sciences, 324–332–324–332.

Rigustia, R., Zeffira, L., & Van, A. T. (2019). Faktor risiko yang berhubungan dengan kejadian pneumonia pada balita di Puskesmas Ikur Koto Kota Padang. Health Medical Journal, 1(1), 22–29.

Riskin, A., Almog, M., Peri, R., Halasz, K., Srugo, I., & Kessel, A. (2012). Changes in immunomodulatory constituents of human milk in response to active infection in the nursing infant. Pediatric Research, 71(2), 220–225.

Ruuskanen, O., Lahti, E., Jennings, L. C., & Murdoch, D. (2011). Viral pneumonia. The Lancet, 377(9773), 1264–1275.

Sabbaj, S., Ibegbu, C. C., & Kourtis, A. P. (2012). Cellular immunity in breast milk: implications for postnatal transmission of HIV-1 to the infant. In Human Immunodeficiency Virus type 1 (HIV-1) and Breastfeeding (pp. 161–169). Springer.

Sonego, M., Pellegrin, M. C., Becker, G., & Lazzerini, M. (2015). Risk factors for mortality from acute lower respiratory infections (ALRI) in children under five years of age in low and middle-income countries: a systematic review and meta-analysis of observational studies. Plos One, 10(1), e0116380.

Sugihartono, S., Rahmatullah, P., & Nurjazuli, N. (2012). Analisis faktor risiko kejadian pneumonia pada balita di wilayah kerja Puskesmas Sidorejo Kota Pagar Alam. Jurnal Kesehatan Lingkungan Indonesia, 11(1), 82–86.

Suzuki, M., Thiem, V. D., Yanai, H., Matsubayashi, T., Yoshida, L. M., Tho, L. H., Minh, T. T., Anh, D. D., Kilgore, P. E., & Ariyoshi, K. (2009). Association of environmental tobacco smoking exposure with an increased risk of hospital admissions for pneumonia in children under 5 years of age in Vietnam. Thorax, 64(6), 484–489.

The United Nations Children’s Fund, World Bank Group, World health Organization, & United Nations. (2021). Levels & Trends in Child Mortality.

Tsutsumi, A., Kayaba, K., Yoshimura, M., Sawada, M., Ishikawa, S., Sakai, K., Gotoh, T., Nago, N., & Jichi Medical School Cohort Study, G. (2003). Association between job characteristics and health behaviors in Japanese rural workers. International Journal of Behavioral Medicine, 10(2), 125–142.

Ujunwa, F. A., & Ezeonu, C. T. (2014). Risk factors for acute respiratory tract infections in under?five children in enugu Southeast Nigeria. Annals of Medical Health Sciences Research, 4(1), 95–99.

UNICEF Indonesia. (2020). Situasi Anak di Indonesia.

VCU Center on Society and Health. (2015). Why Education Matters to Health: Exploring the Causes (February 13, 2015). Virginia Commonwealth University.

Victora, C. G., Fuchs, S. C., Flores, J. A. C., Fonseca, W., & Kirkwood, B. (1994). Risk factors for pneumonia among children in a Brazilian metropolitan area. Pediatrics in Review, 93(6), 977–985.

Wijaya, F. A. (2019). ASI Eksklusif: Nutrisi Ideal untuk Bayi 0-6 Bulan. Cermin Dunia Kedokteran, 46(4), 296–300.

World Health Organization. (2021). Pneumonia.

World Health Organization, & The United Nations Children’s Fund. (2013). Ending preventable child deaths from pneumonia and diarrhoea by 2025: the integrated global action plan for pneumonia and diarrhoea (GAPPD).

Yudiastuti, N. K. E., Sawitri, A. A. S., & Wirawan, D. N. (2015). Durasi Pemberian ASI Eksklusif, Lingkungan Fisik dan Kondisi Rumah sebagai Faktor Risiko Pneumonia padA Balita di Puskesmas II Denpasar Selatan. Public Health Preventive Medicine Archive, 3(2), 115–123.

Zheng, X., Qian, H., Zhao, Y., Shen, H., Zhao, Z., Sun, Y., & Sundell, J. (2013). Home risk factors for childhood pneumonia in Nanjing, China. Chinese Science Bulletin, 58(34), 4230–4236.

Article Statistic

Abstract view : 25 times
PDF (Bahasa Indonesia) views : 21 times

Dimensions Metrics

How To Cite This :


  • There are currently no refbacks.

Copyright (c) 2022 Asep Hermawan

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.