ArticleBMC health services research2026
Healthcare system preparedness as a mediating factor in climate-driven tuberculosis outcomes: an ecological study.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClimate change may influence tuberculosis (TB) transmission through environmental and health system pathways. It is important to understand how the health system can adapt to reduce the impact of climate change on TB transmission.
methodsWe conducted an ecological study using district-level data from the Indonesian Health Facility Research Survey, the National Health Insurance data sample registry, and monthly climate indicators (temperature, humidity, precipitation) for 2019. Mediation analysis was applied to assess the role of healthcare preparedness in mediating the relationship between climatic variability and TB incidence.
resultsHealthcare preparedness fully mediated the association between humidity and TB incidence. The indirect effect through healthcare preparedness was statistically significant (α × β = 0.0021, 95% CI: 0.0008, 0.0035), while the direct effect was not (c
conclusionThese findings highlight the importance of targeted investments to strengthen healthcare systems in high-burden, climate-vulnerable districts. Integrating climate adaptation into TB control programs and enhancing surveillance are essential to ensure accurate burden estimation, effective resource allocation, and resilience against the combined challenges of climate variability and TB transmission.
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