Determination of Environmental Sanitation Factors as a Risk Factor for Diarrhea in KaoFe Village, Buton Regency: A Public Health Approach
Abstract
Purpose of the study: This study aimed to analyze environmental sanitation factors as determinants of diarrhea incidence in Desa KaoFe, Kecamatan Kadatua, Kabupaten Buton.
Methodology: A quantitative analytic study with a cross-sectional design was conducted among 156 randomly selected households from a population of 260 households. Data were collected through structured interviews and direct observation of sanitation facilities. Variables included access to clean water, household latrine availability, solid waste management, wastewater disposal, and diarrhea incidence within the last three months. Data were analyzed using descriptive statistics and Chi-square tests at a 95% confidence level.
Main Findings: The prevalence of diarrhea was 31.4%. Households without adequate clean water access accounted for 34.6%, unhealthy or absent latrines 43.6%, inadequate solid waste management 49.4%, and improper wastewater disposal 75.6%. All sanitation variables showed statistically significant associations with diarrhea incidence (p < 0.05).
Novelty/Originality of this study: This study provides a multidimensional assessment of sanitation determinants within a small island rural context, demonstrating that wastewater disposal and integrated sanitation deficiencies play a critical role in diarrhea transmission beyond water access alone.
References
A. Liberati et al., “The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration,” PLoS Med., vol. 6, no. 7, pp. 1–28, 2009, doi: 10.1371/journal.pmed.1000100.
J. G. Djokoto, P. Pomeyie, and C. A. Wongnaa, “Foreign direct investment in food manufacturing and stages of human development,” Cogent Econ. Financ., vol. 11, no. 2, 2023, doi: 10.1080/23322039.2023.2267738.
O. H. Gumara, A. S. Wahyuri, D. Damrah, and N. Ihsan, “Effectiveness of e-modules for physical education, sports and health subjects in improving learning outcomes of junior high school students,” Edumaspul J. Pendidik., vol. 7, no. 1, pp. 1320–1327, 2023, doi: 10.33487/edumaspul.v7i1.6037.
N. Alam, H. R. Chowdhury, A. Ahmed, M. Rahman, and P. Kim Streatfield, “Distribution of cause of death in rural Bangladesh during 2003-2010: Evidence from two rural areas within matlab health and demographic surveillance site,” Glob. Health Action, vol. 7, no. 1, 2014, doi: 10.3402/gha.v7.25510.
D. C. Karaferis, D. A. Niakas, D. Balaska, and A. Flokou, “Valuing outpatients’ perspective on primary health care services in greece: A cross-sectional survey on satisfaction and personal-centered care,” Healthcare, vol. 12, no. 14, pp. 1–20, Jul. 2024, doi: 10.3390/healthcare12141427.
J. Singh, B. Matthees, and A. L. Odetunde, “Leaning online education during COVID-19 pandemic attitudes and perceptions of non-traditional adult learners,” Qual. Assur. Educ., vol. 29, no. 4, pp. 408–421, 2021, doi: 10.1108/QAE-12-2020-0147.
E. K. Odjer and E. K. G. Mensah, “Maternal mortality and legal accountability: Examining government responsibility for preventable deaths,” J. Law Crim. Justice, vol. 13, no. 5, pp. 49–73, Sep. 2025, doi: 10.15640/jlcj.v13p4.
M. M. Mugambi, “Inculcating values among learners in schools: An analysis of global practices and approaches,” J. Educ. Train., vol. 9, no. 2, p. 178, 2022, doi: 10.5296/jet.v9i2.20055.
M. Kiran, Y. Xie, N. Anjum, G. Ball, B. Pierscionek, and D. Russell, “Machine learning and artificial intelligence in type 2 diabetes prediction: a comprehensive 33-year bibliometric and literature analysis,” Front. Digit. Heal., vol. 7, no. 2, pp. 1–27, 2025, doi: 10.3389/fdgth.2025.1557467
A. Musa et al., “Antimicrobial activities of the extracts and secondary metabolites from Clausena genus – A review,” Open Chem., vol. 20, no. 1, pp. 627–650, 2022, doi: 10.1515/chem-2022-0176.
D. A. Majeed et al., “Data analysis and machine learning applications in environmental management,” J. Ilm. Ilmu Terap. Univ. Jambi, vol. 8, no. 2, pp. 398–408, 2024, doi: 10.22437/jiituj.v8i2.32769.
D. Nandari, A. A. M. Semariyani, and N. M. A. S. Singapurwa, “Chemical and microbiology analysis of salted anchovies (Stolephorus sp.) in east Denpasar traditional market,” SEAS (Sustainable Environ. Agric. Sci., vol. 4, no. 2, pp. 120–129, 2020, doi: 10.22225/seas.4.2.2621.120-129.
Sutomo, “Short Communication: Plant Diversity Utilization and Land Cover Composition in the Subak Jatiluwih, Bali, Indonesia,” Biodiversitas, 2021, doi: 10.13057/biodiv/d220345.
S. B. Prayitno, Sarwan, and Sarjito, “The diversity of gut bacteria associated with milkfish (Chanos chanos forsksal) from northern coast of central Java, Indonesia,” Procedia Environ. Sci., vol. 23, no. Ictcred 2014, pp. 375–384, 2015, doi: 10.1016/j.proenv.2015.01.054.
H. Yin, S. Huang, and W. Wang, “Work environment characteristics and teacher well-being: The mediation of emotion regulation strategies,” Int. J. Environ. Res. Public Health, vol. 13, no. 9, 2016, doi: 10.3390/ijerph13090907.
E. J. Kim and Y. S. Roh, “Competence‐based training needs assessment for basic life support instructors,” Nurs. Health Sci., vol. 21, no. 2, pp. 198–205, 2019, doi: 10.1111/nhs.12581.
C. Palermo et al., “Setting priorities for health education research: A mixed methods study,” Med. Teach., vol. 41, no. 9, pp. 1029–1038, 2019, doi: 10.1080/0142159X.2019.1612520.
M. Kennedy-Martin et al., “Which multi-attribute utility instruments are recommended for use in cost-utility analysis? A review of national health technology assessment (HTA) guidelines,” Eur. J. Heal. Econ., vol. 21, no. 8, pp. 1245–1257, 2020, doi: 10.1007/s10198-020-01195-8.
F. Saltan and Ö. Arslan, “The use of augmented reality in formal education: A scoping review,” Eurasia J. Math. Sci. Technol. Educ., vol. 13, no. 2, pp. 503–520, 2017, doi: 10.12973/eurasia.2017.00628a.
M. M. D. Wahyuni et al., “Epidemiological surveillance on diarrheal diseases at pasir panjang primary health care center 2025,” J. Widya Med., vol. 11, no. 2, pp. 100–110, Aug. 2025, doi: 10.33508/jwm.v11i2.7508.
O. J. Sumampouw, J. E. Nelwan, F. V. Kuhon, O. R. Pinontoan, E. C. Musa, and J. Tahulending, “The determinants of the incidence of diarrhea in underfive children in Urban coastal areas: A Cross-sectional study,” Int. J. Nat. Heal. Sci., vol. 4, no. 1, pp. 37–50, 2026, doi: 10.59890/ijnhs.v4i1.147.
Dewi Suparti, E. C. Situmorang, R. Hasugian, R. Situmorang, and F. Diniarti, “Diarrhea prevention and treatment counseling In Suka Maju Village, penarik district, Mukomuko regency,” J. Inov. Kerja Nyata, vol. 1, no. 1, pp. 51–56, Jul. 2025, doi: 10.70963/jikn.v1i1.833.
Y.-E. Cha, Y.-Z. Fu, and W. Yao, “Knowledge, practice of personal hygiene, school sanitation, and risk factors of contracting diarrhea among Rural students from fivew western provinces in China,” Int. J. Environ. Res. Public Health, vol. 18, no. 18, p. 9505, Sep. 2021, doi: 10.3390/ijerph18189505.
D. Cendekia, D. Ayu Afifah, and W. Hanifah, “Linearity graph in the prediction of granular active carbon (GAC) adsorption ability,” IOP Conf. Ser. Earth Environ. Sci., vol. 1012, no. 1, 2021, doi: 10.1088/1755-1315/1012/1/012079.
M. W. A. Kesiman and K. Agustini, “The Implementation of hypertext-based learning media for a local cultural based learning,” J. Inf. Technol. Educ. Innov. Pract., vol. 11, pp. 377–385, 2012, doi: 10.28945/1741.
J. Novotný and B. G. Mamo, “Household-level sanitation in Ethiopia and its influencing factors: A systematic review,” BMC Public Health, vol. 22, no. 1, p. 1448, 2022, doi: 10.1186/s12889-022-13822-5.
A. M. Rubeba, “Lecturers’ teaching competencies towards improving teaching and learning process in universities in Tanzania: Students’ perspectives,” Heliyon, vol. 11, no. 1, p. e41683, 2025, doi: 10.1016/j.heliyon.2025.e41683.
J. Y. Ho et al., “Towards an integrated approach to improve the understanding of the relationships between water-borne infections and health outcomes: Using Malaysia as a detailed case study,” Front. Water, vol. 4, no. 3, pp. 1–8, Mar. 2022, doi: 10.3389/frwa.2022.779860.
M. Abduh, T. Alawiya, G. Apriansyah, R. A. Sirodj, and M. W. Afgani5), “Survey design: Cross sectional dalam penelitian kualitatif,” J. Pendidik. Sains dan Komput., vol. 3, no. 1, pp. 31–39, 2023, doi: 10.22437/jiituj.v5i1.12886.
S. Sousa, E. Correia, J. Leite, and C. Viseu, “Environmental knowledge, attitudes and behavior of higher education students: a case study in Portugal,” Int. Res. Geogr. Environ. Educ., vol. 0, no. 0, pp. 1–18, 2020, doi: 10.1080/10382046.2020.1838122.
S. T. Nihan, “Karl pearsons chi-square tests,” Educ. Res. Rev., vol. 15, no. 9, pp. 575–580, 2020, doi: 10.5897/err2019.3817.
A. K. Mbah and A. Paothong, “Shapiro–francia test compared to other normality test using expected p-value,” J. Stat. Comput. Simul., vol. 85, no. 15, pp. 3002–3016, 2015, doi: 10.1080/00949655.2014.947986.
A. M. Aljeboree, “Direct dyes derived from 4 , 4 -diaminobenzanilide synthesis , characterization and toxicity evaluation of a disazo symmetric direct dye,” Bioresour. Technol., vol. 2, no. 3, pp. 1–12, 2014, doi: 10.1007/s12257-009-0199-4
L. A. Mukadar, T. Joko, and O. Setiani, “Liquid Waste pollution load analysis home industry batik and the impact on the quality of river water in the sub-district of Pekalongan Selatan, Pekalongan City,” Int. J. Heal. Educ. Soc., vol. 4, no. 11, pp. 47–60, 2021, doi: 10.1234/ijhes.v4i11.206.
T. U. Zaman, H. D. Goswami, and Y. Hassan, “The impact of growth and development of slums on the health status and health awareness of slum dwellers,” Int. J. Med. Res. Heal. Sci., vol. 7, no. 3, pp. 55–65, 2018.
M. C. da C. Carvalho, S. A. Ribeiro, L. S. de Sousa, A. Â. M. Lima, and B. L. L. Maciel, “Undernutrition and intestinal infections in children: A narrative review,” Nutrients, vol. 17, no. 9, p. 1479, Apr. 2025, doi: 10.3390/nu17091479.
E. U. Alum, E. I. Obeagu, and O. P.-C. Ugwu, “Enhancing quality water, good sanitation, and proper hygiene is the panacea to diarrhea control and the attainment of some related sustainable development goals: A review,” Medicine (Baltimore)., vol. 103, no. 38, p. e39578, 2024, doi: 10.1097/MD.0000000000039578.
Cominola, A., Preiss, L., Thyer, M., et al., “The determinants of household water consumption: A review and assessment framework for research and practice,” npj Clean Water, vol. 6, Art. no. 11, 2023, doi: 10.1038/s41545-022-00208-8.
Yan, J., Yin, C., An, Z., Mu, B., Wen, Q., Li, Y., Zhang, Y., Chen, W., Wang, L., and Song, Y., “The influence of urban form on land surface temperature: A comprehensive investigation from 2D urban land use and 3D buildings,” Land, vol. 12, no. 9, Art. no. 1802, 2023, doi: 10.3390/land12091802.
W. Wasehudin, I. Anshori, M. T. Rahman, I. Syafe’i, and G. C. Kesuma, “A creativity education model for coastal communities amid the Covid-19 pandemic,” J. Environ. Manag. Tour., vol. 12, no. 3, pp. 729–741, 2021, doi: 10.14505//jemt.12.3(51).12.
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