Abstract
<title>Abstract</title> <p>Background Dengue fever remains a persistent public health challenge in Indonesia, particularly in areas with rapid urbanization and heterogeneous household environmental conditions. In South Sulawesi, dengue transmission may be influenced by housing quality, water, sanitation and hygiene conditions, and household mosquito breeding-site control. This study aimed to identify household environmental and behavioural factors associated with dengue fever in South Sulawesi using data from the 2023 Indonesian Health Survey. Methods This cross-sectional analytical study used secondary data from respondents residing in South Sulawesi. Dengue fever was defined as self-reported physician-diagnosed dengue within the previous year. Independent variables included sewage system, house roof, ceiling, floor, wall, and dengue preventive behaviour. Descriptive statistics were used to summarize respondent and household characteristics. Bivariate analysis was performed using chi-square tests and crude odds ratios with 95% confidence intervals. Significant variables were further examined using multivariable logistic regression with the backward likelihood ratio method. Results Among 46,514 respondents, 308 dengue fever cases were reported. The weighted dengue prevalence in South Sulawesi was 0.77% (95% CI: 0.63–0.94), higher than the national estimate of 0.64% (95% CI: 0.59–0.70). Most households had sewage systems that did not meet standards (92.0%) and ceilings that did not meet standards (84.2%). Bivariate analysis showed that substandard roof condition was significantly associated with dengue fever (OR = 2.02; 95% CI: 1.28–3.20; p = 0.003). Floor condition and preventive behaviour were also significantly associated. In the final model, roof condition and preventive behaviour remained significant predictors. Conclusions Dengue fever in South Sulawesi is associated with household environmental and behavioural factors. These findings support integrated dengue control strategies combining housing improvement, WASH strengthening, community-based 3M Plus practices, and household-level vector surveillance.</p>