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.