Identifying risk factors for soil-transmitted helminths among indigenous communities in Simalungun, North Sumatra

Soil-transmitted helminths (STH) are among the most common parasitic infections associated with neglected tropical diseases (NTDs), particularly in regions with poor sanitation and hygiene. The prevalence of STH is disproportionately high in middle- to low-income countries due to inadequate infrastructure and hygiene practices. This study aimed to identify risk factors associated with STH infections among native communities in the rural Simalungun District, North Sumatra, Indonesia. A cross-sectional study was conducted among 592 native Simalungun Bataknese individuals living and working in 14 villages across the district. Participants were interviewed regarding sanitation, hygiene practices, and demographic factors, while fecal samples were collected for parasitological examination using the direct smear and Kato-Katz methods. All laboratory analyses were conducted at the Parasitology Laboratory, Faculty of Medicine, Universitas Sumatera Utara, and interpreted by a parasitologist. Statistical analysis was performed using chi-square tests and multivariate logistic regression to identify significant risk factors for STH infection. The overall STH prevalence was 14.5% (86/592 participants), with identified species including Trichuris trichiura (33.7%), hookworm (31.4%), Ascaris lumbricoides (11.6%), and mixed infections (23.3%). Multivariate analysis revealed two significant risk factors for STH infection: consumption of uncooked drinking water (AOR 2.05, 95% CI 1.10-3.81, p=0.000) and not using a toilet with a septic tank (AOR 2.38, 95% CI 1.46-3.87). These findings highlight the critical role of sanitation and water safety in reducing STH transmission. Improving access to safe drinking water and proper sanitation facilities is essential for controlling STH infections in rural communities.