Paparan asap rokok dan status imunisasi sebagai faktor risiko dominan kejadian infeksi saluran pernapasan akut pada balita di BLUD Puskesmas Timika: Tobacco smoke exposure and immunization status as dominant risk factors for acute respiratory infections among children under five at BLUD Puskesmas Timika

Ririn Andriani Ibrahim (Fakultas Kesehatan Masyarakat, Universitas Cenderawasih)
Rosmin Tingginehe (Fakultas Kesehatan Masyarakat, Universitas Cenderawasih)
Arius Togodly (Fakultas Kesehatan Masyarakat, Universitas Cenderawasih)
Muhammad Akbar Nurdin (Fakultas Kesehatan Masyarakat, Universitas Cenderawasih)
Sarce Makaba (Fakultas Kesehatan Masyarakat, Universitas Cenderawasih)
Novita Medyati (Fakultas Kesehatan Masyarakat, Universitas Cenderawasih)

Jurnal Keperawatan Tropis Papua
Vol. 9 No. 1 (2026): JUNI 2026

Infeksi saluran pernapasan akut (ISPA) merupakan penyebab utama morbiditas dan mortalitas balita di negara berkembang. Provinsi Papua Tengah mencatat prevalensi ISPA balita sebesar 11,8%, jauh melampaui rata-rata nasional 4,8%, sementara data epidemiologis spesifik dari BLUD Puskesmas Timika belum tersedia sebelumnya. Penelitian ini bertujuan menganalisis faktor risiko kejadian ISPA pada balita dan mengidentifikasi faktor yang paling dominan. Penelitian cross-sectional dilakukan pada 151 balita yang berkunjung ke Poli MTBS BLUD Puskesmas Timika pada Maret 2026, dipilih secara consecutive sampling. Data dikumpulkan melalui rekam medis elektronik, formulir MTBS, dan kuesioner terstruktur, dianalisis secara bivariat dengan uji chi-square dan estimasi odds ratio (OR), dilanjutkan regresi logistik backward untuk analisis multivariat. Sebanyak 100 dari 151 balita (66,2%) terdiagnosis ISPA. Paparan asap rokok merupakan faktor dominan (OR adj 4,012; 95% CI 1,871–8,603; p < 0,001), diikuti imunisasi tidak lengkap (OR adj 2,813; 95% CI 1,323–5,981; p = 0,007). Balita yang terpapar asap rokok sekaligus memiliki imunisasi tidak lengkap mencatat proporsi ISPA tertinggi (84,3%). Status gizi, riwayat berat badan lahir rendah, ASI eksklusif, dan pendidikan ibu tidak berhubungan bermakna. Intervensi pencegahan ISPA di wilayah ini perlu mengintegrasikan pengendalian paparan asap rokok dalam rumah tangga dan penguatan cakupan imunisasi dasar secara bersamaan. Acute respiratory infection (ARI) is a leading cause of morbidity and mortality in children under five in developing countries. Central Papua Province recorded an ARI prevalence of 11.8% among children under five, exceeding the national average of 4.8%, while no prior epidemiological data specific to BLUD Puskesmas Timika were available. This study aimed to analyze risk factors associated with ARI in children under five and identify the most dominant factor. A cross-sectional study was conducted among 151 children under five attending the IMCI Clinic at BLUD Puskesmas Timika in March 2026, selected by consecutive sampling. Data were collected from electronic medical records, IMCI forms, and structured questionnaires, analyzed using chi-square tests with crude odds ratio estimation, followed by backward logistic regression. Of 151 children, 100 (66.2%) were diagnosed with ARI. Tobacco smoke exposure was the most dominant factor (aOR 4.012; 95% CI 1.871–8.603; p < 0.001), followed by incomplete immunization (aOR 2.813; 95% CI 1.323–5.981; p = 0.007). Children simultaneously exposed to tobacco smoke and with incomplete immunization recorded the highest ARI proportion (84.3%). Nutritional status, low birth weight history, exclusive breastfeeding, and maternal education showed no significant association. ARI prevention programs in this setting should integrate household smoking control with strengthened immunization coverage simultaneously.