Understanding lymphatic filariasis risk in endemic regions: Associations with preventive behaviours, environmental factors, and other mosquito-borne diseases
- 1Department of Environmental Health, Faculty of Public Health, Universitas Sriwijaya, Indralaya 30862, Indonesia
- 2Department of Public Health and Epidemiology, Faculty of Medicine, Universitas Pelita Harapan, Tangerang 15811, Indonesia
Abstract
Lymphatic filariasis (LF) remains a major public health challenge in Indonesia, where transmission persists despite more than a decade of mass drug administration (MDA). Using data from the nationally representative Indonesia Health Survey (SKI 2023) (n = 520,505), we examined the demographic, behavioural, environmental, and other mosquito-borne disease associations of self-reported LF in Indonesia. We conducted a cross-sectional, weighted analysis of SKI 2023 with multivariable logistic regression and rural/urban stratified models to identify factors independently associated with LF. Overall self-reported LF prevalence was 1.9%. After adjustment, children aged 0–17 years had higher odds of LF (aOR = 1.36; p < 0.001), and females had slightly increased odds (aOR = 1.07; p = 0.001). Skipping preventive drugs under health worker supervision was strongly associated with LF (aOR = 2.49, p < 0.001). Use of pit or open-hole latrines was independently associated with increased odds (aOR = 1.15; p < 0.001). Paradoxically, not sleeping under insecticide-treated nets (≤3 years or > 3 years) was associated with lower odds of LF (aOR = 0.91; p = 0.044 and aOR = 0.83; p < 0.001, respectively). Co-occurrence with malaria and dengue was observed in bivariate analyses (ORs 2.63; 4.31), suggesting overlapping vector ecologies. Persistent, heterogeneous LF in Indonesia is linked to gaps in supervised MDA, inadequate sanitation, and overlap with other mosquito-borne diseases. Strengthening directly observed MDA, integrating WaSH and locally tailored vector management, and enhancing entomological and parasitological surveillance are critical for evidence-based, multisectoral One Health strategies to accelerate national LF elimination.
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BibTeX
@article{saputra2026understanding,
title = {{Understanding lymphatic filariasis risk in endemic regions: Associations with preventive behaviours, environmental factors, and other mosquito-borne diseases}},
author = {Yoerdy Agusmal Saputra and Rohana Uly Pradita Siregar},
journal = {One Health},
year = {2026},
month = oct,
doi = {10.1016/j.onehlt.2026.101614},
url = {https://doi.org/10.1016/j.onehlt.2026.101614},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Understanding lymphatic filariasis risk in endemic regions: Associations with preventive behaviours, environmental factors, and other mosquito-borne diseases
AU - Yoerdy Agusmal Saputra
AU - Rohana Uly Pradita Siregar
PY - 2026
DA - 2026/10/15
JO - One Health
DO - 10.1016/j.onehlt.2026.101614
UR - https://doi.org/10.1016/j.onehlt.2026.101614
AB - Lymphatic filariasis (LF) remains a major public health challenge in Indonesia, where transmission persists despite more than a decade of mass drug administration (MDA). Using data from the nationally representative Indonesia Health Survey (SKI 2023) (n = 520,505), we examined the demographic, behavioural, environmental, and other mosquito-borne disease associations of self-reported LF in Indonesia. We conducted a cross-sectional, weighted analysis of SKI 2023 with multivariable logistic regression and rural/urban stratified models to identify factors independently associated with LF. Overall self-reported LF prevalence was 1.9%. After adjustment, children aged 0–17 years had higher odds of LF (aOR = 1.36; p < 0.001), and females had slightly increased odds (aOR = 1.07; p = 0.001). Skipping preventive drugs under health worker supervision was strongly associated with LF (aOR = 2.49, p < 0.001). Use of pit or open-hole latrines was independently associated with increased odds (aOR = 1.15; p < 0.001). Paradoxically, not sleeping under insecticide-treated nets (≤3 years or > 3 years) was associated with lower odds of LF (aOR = 0.91; p = 0.044 and aOR = 0.83; p < 0.001, respectively). Co-occurrence with malaria and dengue was observed in bivariate analyses (ORs 2.63; 4.31), suggesting overlapping vector ecologies. Persistent, heterogeneous LF in Indonesia is linked to gaps in supervised MDA, inadequate sanitation, and overlap with other mosquito-borne diseases. Strengthening directly observed MDA, integrating WaSH and locally tailored vector management, and enhancing entomological and parasitological surveillance are critical for evidence-based, multisectoral One Health strategies to accelerate national LF elimination.
SN - 2352-7714
ER -