Association among ecological and behavioural attributes, dengue vector and disease control: a cross-sectional study of the city of Dhaka, Bangladesh

Public knowledge, belief, and preventive practices regarding dengue: Findings from a community-based survey in rural Bangladesh

BACKGROUND

Dengue fever, the most prevalent mosquito-borne viral infection, is a recurrent public health threat in Bangladesh. Despite the government's efforts, dengue outbreaks are on the upswing, and people's knowledge, belief, and preventive practices regarding the disease at the rural community level are unclear.

OBJECTIVE

The objective of this study was to assess the level of knowledge, belief and preventive practices regarding dengue and associated factors among community people from rural Bangladesh.

METHODS

A cross-sectional survey was conducted involving 401 people using a convenient sampling technique from three unions of Savar from August to September 2021. Participants' responses were collected through face-to-face interviews using a pre-tested structured questionnaire that included information related to socio-demographics, dengue-related knowledge, preventive practices, and the health belief model (HBM) constructs. Multiple linear regression analysis was performed to determine the factors associated with the knowledge and preventive practices of dengue.

RESULTS

Overall, participants (mean age = 33.47 ± 12.96 years; age range = 18-75 years) correctly answered 66.15% of the knowledge questions regarding dengue. Higher education, travel to dengue-risk regions, and self-efficacy under the HBM construct were all shown to be strongly associated with dengue knowledge. Regarding HBM constructs, about 80% of the participants perceived dengue as dangerous, but less than half (41.4%) believed themselves susceptible to dengue. Considering perceived barriers, 73.07% of the participants believed their residential area was not suitable for Aedes mosquito breeding. Nearly all (93.52%) believed they always kept their surrounding area clean as part of self-efficacy. Moreover, on average participants engaged in 53.69% of all dengue preventive practices. Being older, female, having a higher education, being a service holder, having a good quality of house structure, and perceived susceptibility as well as self-efficacy under the HBM construct were all factors in participants' dengue prevention activities. Participants' dengue preventative practices were shown to be significantly influenced by their knowledge.

CONCLUSIONS

The findings of this study found a moderate level of knowledge regarding dengue among the participants. Regarding dengue prevention, although participants scored highly in several indicators, the overall preventive practices were not satisfactory. This suggests that there is a pressing need for expanded education outreach aimed at increasing public awareness of dengue and encourage preventive practices within rural communities in Bangladesh.

Dengue in Dhaka, Bangladesh: Hospital-based cross-sectional KAP assessment at Dhaka North and Dhaka South City Corporation area

Dengue, the most important mosquito-borne viral disease of humans is a recurring global health problem. In Bangladesh, dengue outbreaks are on the increase despite the efforts of government and it is not clear what the understanding of the general Dhaka population towards dengue fever is. Knowledge, attitude and practice (KAP) studies are essential guides in public health interventions. Hence, using KAP, this study aims to assess patient-perspectives with regards to factors associated with dengue, as well as investigate the associated factors between the two corporations in Dhaka. A Hospital-based cross-sectional study of 242 fever patients from two city-corporations in Dhaka (Dhaka North City Corporations, DNCC (n = 91, 37.6%) and Dhaka South City Corporation, DSCC (n = 151, 62.4%) was conducted using pre-tested KAP items. Wilcoxon's Rank Sum was used to determine the KAP by DNCC, DSCC and both corporations and multivariate Poisson regression analyses. The two corporations were analysed separately due to the differences in income distribution, concentration of slums, hospitals and clinics. The study found that more than half of the study population were knowledgeable about dengue (mean percentage scores was 52%), possess an appropriate and acceptable attitude towards the disease (69.2%), and about two thirds of the respondents (71.4%) engaged in practices towards its prevention. After adjusting for the potential cofounders, the factors associated with KAP about dengue fever varied between DNCC and DSCC; with duration of residency and use of mosquito nets were associated with knowledge in the north while income class and age were associated with knowledge and attitude in the south. In the pooled analysis (combining both corporations), knowledge of dengue was associated with good practice towards dengue fever among the respondents. The duration of residence in Dhaka (10+ years), not using mosquito nets and length of time spent in the hospital (7+ days) due to dengue, and decreased knowledge (Adjusted coefficient (β) = -0.01, 95%CI: -0.02, -0.01) were associated with attitude towards dengue in DNCC. On the other hand, middle-high income class, age (40+ years) and increased knowledge were associated with practice towards dengue in DSCC (β = 0.02, 95%CI: 0.01, 0.03). Efforts to increase knowledge about dengue fever through education by the administrations of both corporations would benefit from targeting these high-risk groups for a more sustainable outcome.