Intestinal Parasitic Infections and Associated Behavioral Risk Factors in a Squatter Community in Butwal, Nepal: A Pilot Study

Abstract

Background

Intestinal parasitic infections (IPIs) are among the most prevalent illnesses worldwide. The morbidity associated with IPIs results in health and economic burdens for billions of people worldwide, especially in low-income nations. Increasing urbanization in Nepal has resulted in the formation of squatter communities in urban centers. These communities often face a disproportionate burden of health issues due to the quality of their living environment. This study aims to determine the prevalence of and risk factors for IPIs in the squatter community of Butwal, Nepal.

Methods

A total of 170 individuals were recruited for a cross-sectional study via convenience sampling. Information pertaining to demographic, socioeconomic, and behavioral factors was obtained via structured questionnaires, personal interviews, and direct witnessing during the field visit. Stool samples (n = 170) were examined for intestinal parasite eggs and oocysts via direct wet mount and concentration techniques.

Results

Overall, the prevalence of parasites was 28.8% (5.3% protozoa, 24.7% helminths). Six species of intestinal parasites were detected. Ascaris lumbricoides (21.2%) was the most dominant helminthic parasite, followed by Trichuris trichiura (2.9%), Entamoeba histolytica (2.4%), Cryptosporidium sp. (1.8%), Giardia lamblia (1.8%), and hookworm (1.8%). Multivariate regression analysis revealed that participants who did not trim their nails once a week were more prone to getting a parasitic infection.

Conclusion

The relatively high prevalence of IPIs among participating residents of the Butwal slum may contribute to an increased risk of IPI transmission due to inadequate hygiene behaviors. Among the participants in this study, more than one quarter stated that they do not trim their nails every week, and approximately one-fifth indicated open defecation. Standardized health education regarding the benefits of hand and nail hygiene behaviors may contribute positively in reducing the parasitic burden and interrupting the chain of transmission in developing urban areas such as Butwal.