Prevalence and Risk Factors of Hookworm and Strongyloides stercoralis Co-Infection in Rural Communities of East Kalimantan Province, Indonesia

Abstract

Hookworm, Strongyloides stercoralis, and their co-infections remain significant public health challenges, especially in developing countries, where multiple risk factors facilitate their transmission. In East Kalimantan Province, Indonesia, the prevalence of hookworms, S. stercoralis, and their co-infections is driven by multiple high-risk factors, including limited access to sanitation facilities, poor personal hygiene, and unfavourable environmental conditions. This study aimed to assess the prevalence of hookworm, S. stercoralis, and their co-infections, as well as to examine the correlation between identified risk factors and infection prevalence. Across-sectional study was performed involving 95 participants from the rural community of Muarakaman District and 118 participants from Marangkayu District, East Kalimantan Province, Indonesia. Two diagnostic techniques, Kato-Katz and Koga agar plate (KAP) culture, were used to diagnose hookworm and Strongyloides infections. Pearson’s chi-square test was employed to examine the correlation between environmental risk factors and the prevalence of hookworm infection, S. stercoralisinfection, and their co-infection. Of the 213 samples examined, 154 (27.7%) were positive for hookworm infection, 17 (8.0%) for Strongyloides infection, and 14 (6.6%) for co-infections. Statistical analysis revealed a significant association between habitual raw vegetable consumption and co-infection with hookworms and S. stercoralis (p = 0.020). Analysis of environmental risk factors indicated that soil organic carbon content and cohabitation with individuals infected with hookworms and S. stercoralis were significantly associated with co-infection (p = 0.025 and p = 0.000, respectively). Hookworm, S. stercoralis, and their co-infections exhibit distinct risk factors, particularly concerning soil organic carbon content, rainfall volume and duration, elevation, and village-specific environmental conditions. These factors influence the survival of parasitic larvae and increase the potential for human infection through soil contact and interactions with domestic animals. Personal hygiene practices and the availability of sanitation facilities contribute to these conditions. Important risk factors for these infections should be incorporated into control and prevention programmes aimed at reducing the prevalence of hookworm and S. stercoralis infections.