Neglected by Design: Occupational Parasitic Infections in India's Lower Castes.

Occupational exposure remains a major driver of parasitic infections in India, largely due to caste-based discrimination that severely limits job opportunities for certain communities. Historically marginalized groups, particularly Scheduled Castes (SC) and Scheduled Tribes (ST), often have little choice but to engage in high-risk occupations such as manual scavenging, landless farming, inland and coastal fishing, tea-estate labor, informal mining, and backyard pig-rearing. Passed down through generations of exploitation, these occupations typically involve minimal or no personal protective equipment and significantly raise the risk of infections like hookworm, strongyloidiasis, visceral leishmaniasis, lymphatic filariasis, Taenia solium cysticercosis, and schistosomiasis. Because social discrimination, even in 2025, restricts these groups from accessing safer employment options, they remain trapped in a cycle of poverty and disease. Add to this their living conditions like mud houses, open defecation practices, segregation, non-secure informal jobs without proper healthcare access, and low literacy, and it is clear why these curable infections persist despite national efforts like mass drug administration and vector control. Addressing this issue effectively means directly tackling caste-driven occupational segregation. Workplace-based preventive treatment, targeted surveillance, and equity-focused policies are essential to sustainably eliminate these parasitic infections and finally close these deep-rooted health disparities that are not commonly addressed in both policy-making and literature.