Socioeconomic factors associated with the burden of chronic filariasis as a neglected tropical disease in West Java (2019–2023)

Abstract

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 (ρ = 0.323), poverty depth index (ρ = 0.286), poverty rate (ρ = 0.264), mean years of schooling (ρ = −0.259), and population density (ρ = −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.