Socioeconomic factors associated with the burden of chronic filariasis as a neglected tropical disease in West Java (2019–2023)
DOI:
https://doi.org/10.61511/jevnah.v3i2.2026.3281Keywords:
filariasis, neglected tropical diseases, socioeconomic factorAbstract
Background: Filariasis is one of the major Neglected Tropical Diseases (NTDs) and remains a public health problem in Indonesia, with West Java ranked among the highest burden provinces. However, evidence on how socioeconomic conditions influence Filariasis distribution at the sub-provincial level is still limited. Methods: An ecological panel study was conducted at the district/city level in West Java from 2019 to 2023. Annual chronic filariasis prevalence per 100,000 population was visualized using heatmaps and summarized through temporal and spatial coefficients of variation (CV). Socioeconomic factors, including mean years of schooling, poverty depth index, poverty rate, sanitation and safe water access, health worker ratio, population growth, and population density, were analyzed through Spearman bivariate correlation tests and further examined using a pooled log-linear ordinary least squares (OLS) regression model with year fixed effects and cluster robust standard errors at the district level. Findings: The heatmap revealed persistent spatial disparities, with Sukabumi District consistently exhibiting the highest prevalence. Temporal analysis showed that inter-regional variation decreased substantially, with spatial CV declining from 1.41 in 2019 to 0.55 in 2023, suggesting increasing convergence across districts. Spearman analysis identified significant associations with population growth (p-value = 0.323), poverty depth index (p-value = 0.286), poverty rate (p-value = 0.264), mean years of schooling (p-value = −0.259), and population density (p-value = −0.239). Multivariate log-linear OLS model confirmed population growth as the strongest independent predictor of filariasis prevalence and mean years of schooling remained a significant protective factor associated with reduced disease burden. Conclusion: Filariasis prevalence in West Java became more evenly distributed between 2019 and 2023, although several high-burden districts persist. The findings further indicate that demographic and educational disparities remain key socioeconomic determinants of disease risk, underscoring the importance of integrated control strategies that address rapid population growth while improving access to education. Novelty/Originality of this article: This study provides integration of descriptive spatial temporal and socioeconomic analyses to explain the persistent disparities in filariasis prevalence across districts in West Java, Indonesia.
References
Abou-El-Naga, I. F. (2015). Demographic, socioeconomic and environmental changes affecting circulation of neglected tropical diseases in Egypt. Asian Pacific Journal of Tropical Medicine, 8(11), 881–888. https://doi.org/10.1016/j.apjtm.2015.10.015
Ahumada, J. A., Laoointe, D., & Samuel, M. D. (2004). Modeling the population dynamics of Culex quinquefasciatus (Diptera: Culicidae), along an elevational gradient in Hawaii. Journal of Medical Entomology, 41(6), 1157–1170. https://doi.org/10.1603/0022-2585-41.6.1157
Aisyah, D. N., Kozlakidis, Z., Diva, H., Trimizi, S. N., Sianipar, L. R., Wijayanti, E., Avicena, A. M., & Adisasmito, W. (2022). The spatial-temporal distribution of chronic lymphatic filariasis in Indonesia: A 18-year registry-based analysis. Microbiology Research, 13(4), 681–690. https://doi.org/10.3390/microbiolres13040049
Akogun, O. B., Adewale, B., Mogaji, H. O., Dawodu, R., Bankole, M., Adewlae, A., Abdus-Salam, I. A., Ononogbo, I., Olamiju, F. O., Tehemen, J., & Isiyaku, S. (2025). Confirmatory mapping for lymphatic filariasis a decade after baseline endemicity assessment in highly urbanized settings of Lagos, Nigeria. International Journal of Infectious Diseases, 159, 108014. https://doi.org/10.1016/j.ijid.2025.108014
Alomar, A. A. (2025). Effects of temperature and bacillus velezensis on the development, longevity, and reproduction of culex quinquefasciatus. Biology, 14(4), 357. https://doi.org/10.3390/biology14040357
Annashr, N. N., Amalia, I. S., & Dinh, H. T. P. (2021). Low knowledge and lack of awareness regarding the mass drug administration health promotion as the determinant factors in non-compliance to the mass drug administration health program. Kesmas: National Public Health Journal, 16(1). https://doi.org/10.21109/kesmas.v16i1.3271
Asiedu, S. O., Kwarteng, A., Amewu, E. K. A., Kini, P., Aglomasa, B. C., & Forkuor, J. B. (2021). Financial burden impact quality of life among lymphatic Filariasis patients. BMC Public Health, 21(1), 174. https://doi.org/10.1186/s12889-021-10170-8
Awasthi, K. R., Jancey J., Clements, A. C. A., Rai, R., & Leavy, J. E. (2024). Community engagement approaches for malaria prevention, control and elimination: A scoping review. BMJ Open, 14(2), e081982. https://doi.org/10.1136/bmjopen-2023-081982
Bagonza, A., Gibson, L., Kabiri, L., Bezalel, C., Narahari, S. R. B., Franks, P. J., Musoke, D., & Moffatt, C. (2025). Exploring barriers to accessing treatment for Lymphatic Filariasis through a socio-ecological lens in Buvuma and Napak districts, Uganda. PLOS Neglected Tropical Diseases, 19(1), e0012747. https://doi.org/10.1371/journal.pntd.0012747
Bhuvaneswari, A., Shriram, A. N., Raju, K. H. K., & Kumar, A. (2023). Mosquitoes, lymphatic filariasis, and public health: A systematic review of anopheles and aedes surveillance strategies. Pathogens (Basel, Switzerland), 12(12), 1406. https://doi.org/10.3390/pathogens12121406
Branda, F., Ali, A. Y., Ceccarelli, G., Albanese, M., Binetti, E., Giovanetti, M., Ciccozzi, M., & Scarpa, F. (2024). Assessing the burden of neglected tropical diseases in low-income communities: Challenges and solutions. Viruses, 17(1), 29. https://doi.org/10.3390/v17010029
Butala, C. B., Cave, R. N. R., Fyfe, J., Coleman, P. G., Yang, G.-J., & Welburn, S. C. (2024). Impact of COVID-19 on the neglected tropical diseases: A scoping review. Infectious Diseases of Poverty, 13(1), 55. https://doi.org/10.1186/s40249-024-01223-2
Ca, J., Kumar P, V. B., Kandi, V., N, G., K, S., Dharshini, D., Batchu, S. V. C., & Bhanu, P. (2024). Neglected tropical diseases: A comprehensive review. Cureus, 16(2), e53933. https://doi.org/10.7759/cureus.53933
Chaturvedi, R., & Sharma, A. (2025). Key facets for the elimination of vector-borne diseases filariasis, leishmaniasis, and malaria. ACS Infectious Diseases, 11(2), 287–304. https://doi.org/10.1021/acsinfecdis.4c00431
Chiphwanya, J., Mkwanda, S., Kabuluzi, S., Mzilahowa, T., Ngwira, B., Matipula, D. E., Chaponda, L., Ndhlova, P., Katchika, P., Mahebere Chirambo, C., Moses, P., Kumala, J., Chiumia, M., Barrett, C., Betts, H., Fahy, J., Rebollo Polo, M., Reimer, L., Stanton, M. C., … Kelly-Hope, L. A. (2024). Elimination of lymphatic filariasis as a public health problem in Malawi. PLOS Neglected Tropical Diseases, 18(2), e0011957. https://doi.org/10.1371/journal.pntd.0011957
Corley, A. G., Thornton, C. P., & Glass, N. E. (2016). The role of nurses and community health workers in confronting neglected tropical diseases in sub-Saharan Africa: A systematic review. PLoS neglected tropical diseases, 10(9), e0004914. https://doi.org/10.1371/journal.pntd.0004914
Cowell, A. J. (2006). The relationship between education and health behavior: Some empirical evidence. Health Economics, 15(2), 125–146. https://doi.org/10.1002/hec.1019
Douglass, J. (2025). Eliminating lymphatic filariasis as a public health problem. In Applied aymphology: Basics| Daily practice| Perspectives (pp. 477-493). Cham: Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-77734-9_25
Dowling, Z., Armbruster, P., LaDeau, S. L., DeCotiis, M., Mottley, J., & Leisnham, P. T. (2013). Linking mosquito infestation to resident socioeconomic status, knowledge, and source reduction practices in suburban Washington, DC. Ecohealth, 10(1), 36-47. https://doi.org/10.1007/s10393-013-0818-6
El Tantawi, M., Aly, N. M., & Folayan, M. O. (2022). Unemployment and expenditure on health and education as mediators of the association between toothbrushing and global income inequalities. BMC Oral Health, 22(1), 539. https://doi.org/10.1186/s12903-022-02570-y
Ferreira, L. L. G., De Moraes, J., & Andricopulo, A. D. (2022). Approaches to advance drug discovery for neglected tropical diseases. Drug Discovery Today, 27(8), 2278–2287. https://doi.org/10.1016/j.drudis.2022.04.004
Goczek, Ł., Witkowska, E., & Witkowski, B. (2021). How does education quality affect economic growth? Sustainability, 13(11), 6437. https://doi.org/10.3390/su13116437
Hongoh, V., Berrang-Ford, L., Scott, M. E., & Lindsay, L. R. (2012). Expanding geographical distribution of the mosquito, Culex pipiens, in Canada under climate change. Applied Geography, 33, 53–62. https://doi.org/10.1016/j.apgeog.2011.05.015
Houweling, T. A. J., Karim-Kos, H. E., Kulik, M. C., Stolk, W. A., Haagsma, J. A., Lenk, E. J., Richardus, J. H., & De Vlas, S. J. (2016). Socioeconomic inequalities in neglected tropical diseases: A systematic review. PLOS Neglected Tropical Diseases, 10(5), e0004546. https://doi.org/10.1371/journal.pntd.0004546
Jaworski, A., Craig, A. T., Dyer, C. E. F., Goncalves, J., Neuendorf, N., Newland, J., Kelly-Hanku, A., Pomat, W., MacLaren, D., & Vaz Nery, S. (2024). Understanding how neglected tropical diseases programs in five Asia-Pacific countries adjusted to the COVID-19 pandemic: A qualitative study. PLOS Neglected Tropical Diseases, 18(5), e0012221. https://doi.org/10.1371/journal.pntd.0012221
Khalid, A., Abdelgadir, M. A., Ashmaig, A., Ibrahim, A. M., Ahmed, A. M., & Adam, I. (2012). Schistosoma mansoni infection among prenatal attendees at a secondary‐care hospital in central Sudan. International Journal of Gynecology & Obstetrics, 116(1), 10–12. https://doi.org/10.1016/j.ijgo.2011.08.018
Kitole, F. A., Ojo, T. O., Emenike, C. U., Khumalo, N. Z., Elhindi, K. M., & Kassem, H. S. (2024). The impact of poor waste management on public health initiatives in shanty towns in Tanzania. Sustainability, 16(24), 10873. https://doi.org/10.3390/su162410873
Krentel, A., Gyapong, M., McFarland, D. A., Ogundahunsi, O., Titaley, C. R., & Addiss, D. G. (2020). Keeping communities at the centre of efforts to eliminate lymphatic filariasis: Learning from the past to reach a future free of lymphatic filariasis. International Health, 13(Supplement_1), S55–S59. https://doi.org/10.1093/inthealth/ihaa086
Kwarteng, E. V. S., Andam-Akorful, S. A., Kwarteng, A., Asare, D.-C. B., Quaye-Ballard, J. A., Osei, F. B., & Duker, A. A. (2021). Spatial variation in lymphatic filariasis risk factors of hotspot zones in Ghana. BMC Public Health, 21(1), 230. https://doi.org/10.1186/s12889-021-10234-9
Lupi, V., & Marsiglio, S. (2021). Population growth and climate change: A dynamic integrated climate-economy-demography model. Ecological Economics, 184, 107011. https://doi.org/10.1016/j.ecolecon.2021.107011
Magalhães, A. R., Codeço, C. T., Svenning, J.-C., Escobar, L. E., Van De Vuurst, P., & Gonçalves-Souza, T. (2023). Neglected tropical diseases risk correlates with poverty and early ecosystem destruction. Infectious Diseases of Poverty, 12(1), 32. https://doi.org/10.1186/s40249-023-01084-1
Mahmoodi, H., Bolbanabad, A. M., Shaghaghi, A., Zokaie, M., Gheshlagh, R. G., & Afkhamzadeh, A. (2023). Barriers to implementing health programs based on community participation: The Q method derived perspectives of healthcare professional. BMC Public Health, 23(1), 2019. https://doi.org/10.1186/s12889-023-16961-5
Martin, B. M., Cadavid Restrepo, A., Mayfield, H. J., & Lau, C. L. (2024). Towards global elimination of lymphatic filariasis: A systematic review of the application of spatial epidemiological methods to enhance surveillance and support elimination programmes. BMJ Public Health, 2(1), e000534. https://doi.org/10.1136/bmjph-2023-000534
Ministry of Health. (2023a). Laporan kinerja kementrian kesehatan tahun 2023. Kementerian Kesehatan Republik Indonesia.
Ministry of Health. (2023b). Profil kesehatan Indonesia 2023. Kementerian Kesehatan Republik Indonesia.
Moser, S. K., Barnard, M., Frantz, R. M., Spencer, J. A., Rodarte, K. A., Crooker, I. K., Bartlow, A. W., Romero-Severson, E., & Manore, C. A. (2023). Scoping review of Culex mosquito life history trait heterogeneity in response to temperature. Parasites & Vectors, 16(1), 200. https://doi.org/10.1186/s13071-023-05792-3
Murphy, J. W. (2014). Community-based interventions: Philosophy and action. Springer New York. https://doi.org/10.1007/978-1-4899-8020-5
Ojo-Akosile, T., Uwah, E. A., Mufungizi, I., Aborode, A. T., Nkundakozera, M., Rusho, M. A., Bakare-Abidola, T., Izinyon, O., Tochukwu, A. M., Onifade, I. A., Nwosu, K. O. S., & Akilimali, A. (2025). Water, sanitation and hygiene and neglected tropical diseases in the Democratic Republic of Congo: A narrative review and policy perspective. Discover Social Science and Health, 5(1), 147. https://doi.org/10.1007/s44155-025-00306-1
Prat, J. G. I., Alguacil, H. M., Saco, S. P., Essadek, H. O., Garcia, J. M. I., Llena, O. C. I., & Peña, J. M. (2023). Implementation of a community-based public model for the prevention and control of communicable diseases in migrant communities in Catalonia. Tropical Medicine and Infectious Disease, 8(9), 446. https://doi.org/10.3390/tropicalmed8090446
Ragab, S. H., Alkhaibari, A. M., Alharbi, J., Areshi, S. M., Mashlawi, A. M., Embaby, D. M., Tyshenko, M. G., Selim, T. A., & Kamel, M. (2024). Impact of climate change on culex pipiens mosquito distribution in the United States. Sustainability, 17(1), 102. https://doi.org/10.3390/su17010102
Raghupathi, V., & Raghupathi, W. (2020). The influence of education on health: An empirical assessment of OECD countries for the period 1995–2015. Archives of Public Health, 78(1), 20. https://doi.org/10.1186/s13690-020-00402-5
Roswati, Santi, Syafii, A., Mahendra, E., & Tosepu, R. (2021, April). A systematic literature (impact of climate change on filariasis). In IOP Conference Series: Earth and Environmental Science, 755(1), 012083. IOP Publishing. https://doi.org/10.1088/1755-1315/755/1/012083
Sangare, M., Coulibaly, Y. I., Diabate, A. F., Dolo, H., Koureichi, M. M., Diarra, D., Duguay, C., Stephens, M., Diakité, M., Kulkarni, M. A., Nutman, T. B., & Krentel, A. (2025). Factors associated with low coverage in mass drug administration for schistosomiasis in mobile populations in Mali: A cross-sectional study. BMC Infectious Diseases, 25(1), 1240. https://doi.org/10.1186/s12879-025-11626-7
Schudde, L., & Bernell, K. (2019). Educational attainment and nonwage labor market returns in the United States. AERA Open, 5(3). https://doi.org/10.1177/2332858419874056
Sharma, S., Singh, A. K., Singh, T., Kumar, S., & Singh, A. (2025). Field-based assessment of lymphatic filariasis transmission dynamics and intervention outcomes in Varanasi District. Public and Global Health. https://doi.org/10.1101/2025.07.14.25331498
Shechtman, O. (2013). The coefficient of variation as an index of measurement reliability. In S. A. R. Doi & G. M. Williams (Eds.), Methods of Clinical Epidemiology (pp. 39–49). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-642-37131-8_4
Sripa, B., Leonardo, L., Hong, S.-J., Ito, A., & Brattig, N. W. (2022). Status and perspective of asian neglected tropical diseases. Acta Tropica, 225, 106212. https://doi.org/10.1016/j.actatropica.2021.106212
Tan, J. Z. G. (2003). The elimination of lymphatic filariasis: A strategy for poverty alleviation and sustainable development – perspectives from the Philippines. Filaria Journal, 2(1), 12. https://doi.org/10.1186/1475-2883-2-12
Tripathi, B., Roy, N., & Dhingra, N. (2022). Introduction of triple-drug therapy for accelerating lymphatic filariasis elimination in india: lessons learned. The American Journal of Tropical Medicine and Hygiene. https://doi.org/10.4269/ajtmh.21-0964
Tsou, M. T. (2017). Association of education, health behaviors, concerns, and knowledge with metabolic syndrome among urban elderly in one medical center in Taiwan. International Journal of Gerontology, 11(3), 138–143. https://doi.org/10.1016/j.ijge.2016.09.006
Ugbomoiko, U. S., Dalumo, V., Ofoezie, I. E., & Obiezue, R. N. N. (2009). Socio-environmental factors and ascariasis infection among school-aged children in Ilobu, Osun State, Nigeria. Transactions of the Royal Society of Tropical Medicine and Hygiene, 103(3), 223–228. https://doi.org/10.1016/j.trstmh.2008.12.014
Vasconez-Gonzalez, J., Miño, C., Noboa, M. D. L., Tello-De-la-Torre, A., Izquierdo-Condoy, J. S., & Ortiz-Prado, E. (2025). The psychosocial and emotional burden of lymphatic filariasis: A systematic review. PLOS Neglected Tropical Diseases, 19(5), e0013073. https://doi.org/10.1371/journal.pntd.0013073
Wharton-Smith, A., Rassi, C., Batisso, E., Ortu, G., King, R., Endriyas, M., Counihan, H., Hamade, P., & Getachew, D. (2019). Gender-related factors affecting health seeking for neglected tropical diseases: Findings from a qualitative study in Ethiopia. PLOS Neglected Tropical Diseases, 13(12), e0007840. https://doi.org/10.1371/journal.pntd.0007840
WHO. (2022). Impact of COVID-19 on NTD programmes (sixteenth meeting of the strategic and technical advisory group for neglected tropical diseases, pp. 15–26). World Health Organization. http://www.jstor.org/stable/resrep56750.5
WHO. (2023). Global partners pledge US$ 777 million to combat neglected tropical diseases. World Health Organization Website. https://www.who.int/news/item/04-12-2023-global-partners-pledge-usd777-million-to-combat-neglected-tropical-diseases
Williams, T., Karim, M. J., Uddin, S., Jahan, S., Asm, S. M., Forbes, S. P., Hooper, A., Taylor, M. J., & Kelly-Hope, L. A. (2023). Socio-economic and environmental factors associated with high lymphatic filariasis morbidity prevalence distribution in Bangladesh. PLOS Neglected Tropical Diseases, 17(7), e0011457. https://doi.org/10.1371/journal.pntd.0011457
Zajacova, A., & Lawrence, E. M. (2018). The relationship between education and health: reducing disparities through a contextual approach. Annual Review of Public Health, 39(1), 273–289. https://doi.org/10.1146/annurev-publhealth-031816-044628
Zhao, H., Xu, T., & Shen, H. (2025). Global, regional, and national disability-adjusted life years and prevalence of lymphatic filariasis from 1990 to 2021: A trend and health inequality analysis based on the global burden of disease study 2021. PLOS Neglected Tropical Diseases, 19(4), e0013017. https://doi.org/10.1371/journal.pntd.0013017
Downloads
Published
Issue
Section
Citation Check
License
Copyright (c) 2026 Rahmidevi Alfiani, Yosua Darmadi Kosen
This work is licensed under a Creative Commons Attribution 4.0 International License.
