Changes in intestinal parasitic infections in a rural Colombian community: data from 2014 to 2015 and 2022.

Objectives

To describe changes in intestinal parasitic infections in Santa Catalina, Bolívar (Caribbean Colombia) between 2014 and 2015 and 2022, and to assess sociodemographic, hygiene, sanitation, and drinking-water factors associated with infection.

Methods

We analyzed two community-based cross-sectional surveys conducted in the same municipality. In 2014-2015, an age-stratified household sample was recruited; in 2022, adults were recruited by convenience during community ascariasis screening activities. Participants provided two stool samples examined by Kato-Katz and direct microscopy. Using 2014-2015 data, we fitted multivariable logistic regression models for parasitic infection outcomes including a composite household sanitation score and drinking-water exposures. Because the 2022 survey differed in sampling frame and age structure, between-wave comparisons were primarily descriptive and complemented by a restricted analysis among adults residing in the municipal head town.

Results

In 2014-2015 (N = 685), prevalence was 88.5% for any intestinal parasite, 79.9% for protozoa, and 71.1% for helminths. Poorer household sanitation was strongly associated with helminth infection, whereas protozoan infection was more consistently associated with drinking aqueduct water; residence in the municipal head town was protective. In 2022 (N = 209), infection frequency decreased to 26.3% for protozoa and 11.0% for helminths. In the restricted head-town adult comparison, any intestinal parasite declined from 84.7% (2014-2015; N = 137) to 27.0% (2022; N = 185)

Conclusions

Intestinal parasitic infections declined markedly between 2014 and 2015 and 2022 despite persistent structural constraints. Remaining risk was patterned by household sanitation and, for protozoa, by drinking-water exposure, underscoring the need to strengthen safe drinking water and sustain basic sanitation in rural Caribbean Colombia.