(Original Article) Prevalence and Associated Risk Factors of Intestinal Parasitic Infections in a Highland Community of Wang Nam Khiao District, Nakhon Ratchasima Province, Thailand: A Two-Year Study
Keywords:
Intestinal parasitic infection, Prevalence, Risk factors, Repeated cross-sectional survey, Wang Nam Khiao DistrictAbstract
Intestinal parasitic infections remain a problem of public health in the tropical regions, particularly in rural communities with limited sanitation, poor hygiene practices, and environmental factors that facilitate parasite transmission. Despite the continuous implementation of national disease control programs, intestinal parasitic infections persist in certain geographically and culturally specific areas, including northeastern Thailand. However, the epidemiological data is relatively limited in highland rural areas specifically in Wang Nam Khiao District. This study aimed to investigate the two-year prevalence, analyze associated risk factors and confirm opisthorchiasis using molecular biology techniques in this area during 2024-2025. A repeated cross-sectional study was performed in 2024 (n = 183) and 2025 (n = 164), comprising a total of 347 fresh stool samples for simple direct smear, concentration techniques (FECT in 2024, EECT in 2025), and modified Agar Plate Culture (mAPC). PCR-based molecular identification was also carried out in 2025. Sociodemographic and behavioral risk factors were obtained through structured questionnaires. Potential risk factors were determined using logistic regression. The results showed that two-year prevalence of intestinal parasitic infection was 5.19%, decreasing from 6.01% in 2024 to 4.27% in 2025. Soil-transmitted helminths were most common parasites, with hookworm predominant in 2024 and Strongyloides stercoralis in 2025. Notably, Opisthorchis viverrini, a Group 1 carcinogen, was molecularly confirmed in 2025. Significant risk factors varied by year. Agricultural work was associated with infection in 2024, whereas daily alcohol consumption was a consistent risk factor and handwashing after touching pets or stray animals was protective in both years. In conclusion, this study provides valuable baseline data for intestinal parasitic infections and shows that these infections are still present as low levels in this rural highland community. The findings highlight show environmental factor and modifiable behaviors drive infection risk. Ongoing monitoring and targeted health education are key to improving local control.
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