The Interplay Between Household Risk Perception of Parasitic Infections and Water, Sanitation, and Hygiene (WASH) Practices: Evidence From an Urban Poor Community in the Philippines

Background: Parasitic diseases pose challenges in impoverished urban settlements with limited access to clean water, proper hygiene, and sanitation (WASH). This study assesses WASH practices and risk perceptions of parasitic infections among households in the Bataan Shipyard and Engineering Corporation (BASECO) Compound in Manila, an urban poor community in the Philippines. Methods: A cross-sectional study design was employed to collect data through a self-administered questionnaire. Descriptive statistical analysis was performed to assess the sociodemographic profile, household WASH practices, and respondents' risk perception of parasitic infections. Linear regression analysis was utilized to examine the relationship between these variables. Results: A survey was conducted with 363 households, of which 237 (65.3%) used distilled and purified water from the water refilling stations in the community for drinking. Meanwhile, 120 households (33.10%) consumed tap water. Boiling water was a commonly used method (n=146; 56.60%) for treating drinking water. Most households had flush toilets with septic tanks (n=244; 67.20%), water sources for handwashing (n=307; 84.57%) and soap for handwashing (n=356; 98.10%). On average, they washed their hands 6-10 times daily (n=159; 43.80%). Most households were aware that drinking untreated water (n=318; 87.6%), improper food washing (n=309; 85.1%), using contaminated water sources (n=301; 82.9%), and consuming raw or undercooked meat (n=298; 82.1%) could lead to parasitic infections. 316 respondents (87.1%) identified diarrhea as the most common symptom of parasitic infection. Relationships were found between access to drinking water and the number of household members (B=0.191; p-value=0.001), personal hygiene and the respondents' knowledge of parasitic infections (B=0.112; p-value=0.047), and the overall WASH score with household income (B=0.105; p-value=0.045). Conclusions: The WASH conditions in BASECO, Manila need improvement. Factors associated with their WASH practices include risk perception of parasitic diseases, socioeconomic disparity, and household overcrowding. These factors play a crucial role in identifying areas for improvement and promoting health policies for urban poor communities in the Philippines.