Tuberkulosis (TBC) adalah penyakit menular yang masih menjadi salah satu penyebab utama masalah kesehatan di dunia. Kasus TBC di Indonesia termasuk yang tertinggi kedua setelah India dengan persentase kasus mencapai 8,5%. Data Riskesdas tahun 2018 melaporkan prevalensi TBC Paru di Indonesia sebesar 0,42%. Berdasarkan penelusuran literatur, masih sedikit yang mengkaji mengenai faktor risiko TBC Paru dari berbagai level secara bersamaan. Penelitian ini bertujuan untuk menganalisis faktor yang berperan pada level individu dan kelompok secara bersamaan terhadap kejadian TBC Paru di Indonesia menggunakan analisis multilevel. Penelitian ini menggunakan data sekunder dengan menggabungkan data Riskesdas Tahun 2018 sebagai sumber data untuk variabel level individu dan data BPS tahun 2018 sebagai sumber data untuk variabel level provinsi. Data yang berjumlah 938.389 sampel digunakan sebagai sampel penelitian. Berdasarkan hasil penelitian, variabel yang berperan terhadap kejadian TBC Paru pada level individu adalah usia (POR=4,93; 95% CI: 4,36-5,57), tingkat pendidikan (POR=1,63; 95% CI: 1,49-1,77), riwayat penyakit DM (POR= 3,77; 95% CI: 3,32-4,28), kepadatan penduduk (POR= 3,11; 95% CI: 1,81 - 5,33), kemiskinan (POR= 1,35; 95% CI: 1,07 - 1,71), dan ketersediaan fasyankes (POR= 1,36; 95% CI: 0,98 - 1,89). Selain itu, variabel yang berperan terhadap kejadian TBC Paru pada level provinsi adalah kepadatan penduduk (MOR= 1,41), kemiskinan (MOR= 1,46), dan ketersediaan fasyankes (MOR= 1,45). Berdasarkan besar kontribusi, variabel individu (usia, tingkat pendidikan, dan riwayat DM) secara bersama-sama berkontribusi sebesar 2,4%. Pada variabel konteksual, variabel kepadatan penduduk, kemiskinan, dan ketersediaan berkontribusi masing-masing sebesar 4,1%, 0,5% dan 0,8%. Namun, jika ketiga variabel dimasukkan secara bersama-sama ke dalam model, kontribusinya meningkat menjadi 9,3%.

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Tuberculosis (TB) is an infectious disease which is still the main cause of health problems in the world. Indonesia is the second highest country after India with 8.5% of all cases in the world. Riskesdas data in 2018 reported that the prevalence of pulmonary tuberculosis in Indonesia was 0.42%. There have been many studies that have examined the effects of factors contributing to the prevalence of pulmonary TB at individual, environmental, or global level. Based on the results of a literature search, there are still few studies that examine the risk factors for pulmonary tuberculosis from various levels. This study aimed to analyze the factors contributing at the individual and group levels simultaneously on the prevalence of pulmonary TB in Indonesia using multilevel analysis. The study design used was a combination of two study designs (hybrid design)-cross sectional and ecological study designs. This study used secondary data by combining data from two different sources: Riskesdas in 2018 as the data source for individual-level variables and BPS in 2018 as the data source for province-level variables. There were 938.389 samples were used in this study. Based on the result, it is known that the variables that contribute to the incidence of pulmonary tuberculosis at the individual level were age (POR=4.93; 95% CI: 4.36-5.57), level of education (POR=1.63; 95% CI: 1 .49-1.77), history of DM (POR= 3.77; 95% CI: 3.32-4.28), population density (POR= 3.11; 95% CI: 1.81 - 5.33 ), poverty (POR= 1.35; 95% CI: 1.07 - 1.71), and availability of health facilities (POR= 1.36; 95% CI: 0.98 - 1.89). In addition, the variables that contribute to the incidence of pulmonary TB at the provincial level are population density (MOR = 1.41), poverty (MOR = 1.46), and availability of health facilities (MOR = 1.46). = 1.45). Based on the contribution, individual variables (age, education level, and history of DM) together contributed 2.4%. In the contextual variables, population density, poverty and availability contributed respectively 4.1%, 0.5% and 0.8%. However, when these three variables were included in the model together, their contribution increases to 9.3%.