Pemodelan Generalized Additive Mixed Model Pada Data Jumlah Kasus Kusta di Sulawesi Tengah
Abstract
Leprosy is a contagious disease caused by the bacterium Mycobacterium leprae and remains a concern in Indonesia, especially in Central Sulawesi Province, which is classified as a high endemic area. Nationally, in 2022 Central Sulawesi ranked 8th in terms of new leprosy cases. This study aims to model the number of leprosy cases and identify significant factors using the Generalized Additive Mixed Model (GAMM) method. The data used are the number of leprosy cases in 2021–2023 in Central Sulawesi Province. The independent variables used included population density, percentage of poor population, access to proper sanitation, health complaints, number of medical personnel, male population, health services for the elderly, and access to proper drinking water sources. The GAMM model was applied with a P spline smoothing function and parameter estimation using Restricted Maximum Likelihood (REML). The results showed that male population was significantly and positively associated with the number of leprosy cases. The random effect of district/city also indicated variation among regions that was not fully explained by the fixed effects in the model. These findings indicate the presence of statistical association between demographic characteristics and leprosy case counts, as well as heterogeneity among districts/cities, without implying a causal relationship
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