Associations Between Ambient PM2.5 Levels and Children's Pneumonia and Asthma During the COVID-19 Pandemic in Greater Jakarta (Jabodetabek).

Background: Children in Indonesia are especially vulnerable to air pollution due to their developing respiratory systems and unique exposure patterns. As one of the top 50 nations most at risk from environmental degradation, Indonesia faces significant public health concerns, especially in rapidly urbanizing areas such as Greater Jakarta, where emissions from transportation contribute heavily to pollution. This study investigates the relationship between PM_2.5 exposure and cases of asthma and pneumonia in children across Greater Jakarta's 11 cities and districts from 2020 to 2022, aiming to provide essential data for health planning and policy. Methods: The data were collected from NafasID's PM_2.5 monitoring network and local health offices reporting monthly cases of asthma and pneumonia in children. Analytical methods included correlation and regression modeling to assess the association between air pollution and respiratory health across different regions. The results reveal a high number of respiratory disease, with 73,694 pneumonia and 15,825 asthma cases reported. Results: Average PM_2.5 concentration in Greater Jakarta was 42.5 µg/m³, with notable variation between areas. Bekasi District recorded the highest levels, while North Jakarta was lower. Depok City showed the strongest correlation between PM_2.5 and pneumonia (r = 0.61, p = 0.004), indicating a sharp increase in cases with rising PM_2.5, while other areas showed weaker correlations. Asthma cases had weak-to-moderate correlations with PM_2.5, which is largely nonsignificant, suggesting complex factors beyond outdoor air pollution may influence asthma. Conclusion: The findings highlight the critical need for improved air quality measures and targeted public health interventions. Addressing air pollution will be vital for reducing respiratory illness and supporting child health resilience in Indonesia's urban centers.