A knowledge, attitude and practices (KAP) study on dengue among selected rural communities in the Kuala Kangsar district

Socioeconomic and environmental factors associated with dengue fever incidence in Guatemala: Rising temperatures increase dengue risk

Dengue fever is a mosquito-borne illness that infects 390 million people annually. Dengue outbreaks in Guatemala have been occurring more often and at increased rates since the first dengue outbreak in Guatemala in the 1970s. This study will examine environmental and socioeconomic factors associated with dengue in Guatemala at the municipality (county) level. Socioeconomic factors included population density, Mayan population, economic activity, and attending school. Environmental factors included average minimum annual temperature and annual precipitation. The relationship between environmental and socioeconomic variables and dengue fever incidence was initially evaluated through univariate zero-inflated negative binomial models, and then again through three zero-inflated multivariate negative binomial regression models. For all three models, elevation was considered a predictor of zero-inflation. In the combined model, there was a positive relationship between minimum temperature, economic activity and dengue fever incidence, and a negative relationship between population density, Mayan population and dengue fever. Predicted rates of dengue fever incidence and adjusted confidence intervals were calculated after increasing minimum yearly temperature by 1°C and 2°C. The three municipalities with the highest minimum yearly temperature (El Estor, Iztapa, and Panzós) and the municipality of Guatemala, all had an increase in the magnitude of the risk of dengue fever incidence following 1°C and 2°C increase in temperature. This research suggests that these socioeconomic and environmental factors are associated with risk of dengue in Guatemala. The predicted rates of dengue fever also highlight the potential effect that climate change in the form of increasing temperature can have on dengue in Guatemala.

Knowledge, attitude, and practice towards dengue fever among medical students in Sudan: A cross-sectional study

Background

Dengue fever, a neglected tropical disease, exhibits a total seroprevalence of 27% in Sudan. During the recent outbreak, medical students actively participated in health education and community outreach programs. This study aims to assess the knowledge, attitude, and practice (KAP) of medical students regarding Dengue Fever (DF) during its current outbreak in Sudan.

Design and methods

We conducted a cross-sectional study involving medical students from more than 15 Sudanese universities, encompassing 11 states. Data collection took place between October 23 and November 10, 2023, utilizing a Google Form questionnaire. A convenient sampling technique was employed to reach students due to its accessibility and feasibility during the ongoing conflict in Sudan. Correlation and regression analyses were used to identify predictors of KAP and establish associations between KAP domains and socio-demographic factors.

Results

Of 694 medical students, 11% reported a previous infection with DF. Among the participants, 58% demonstrated good knowledge, 74.1% exhibited a positive attitude, and less than half (46.7%) demonstrated good preventive practices. There was a positive correlation between knowledge and attitude levels with the practice level (p < 0.001). Gender, age, and previous DF infection emerged as significant predictors (p < 0.05) of the overall KAP level in multiple logistic regression.

Conclusions

Our study revealed a commendable level of knowledge and attitude but a suboptimal level of practice regarding DF among medical students. This inadequacy in practice, particularly among medical students who are expected to set an example, is concerning and warrants further investigation.

Knowledge, attitude, and practice regarding dengue among non-health undergraduate students of Nepal

Dengue poses a significant public health concern worldwide. It is identified as a recent emerging infectious disease in Nepal. Understanding the situation and dynamics between knowledge, attitudes, and practices (KAP) related to dengue among students is crucial for effective prevention and control strategies. This study aimed to assess the KAP and their associated factors of dengue among non-health undergraduate students of Nepal to identify gaps and suggest appropriate interventions. A web-based cross-sectional study was conducted among 429 non-health undergraduate students at eleven Nepalese Universities, with 80% of participants from the four most prominent ones in the country. Self-administered online forms were administered via Google Forms platform predominantly through social media for data collection. Data was cleaned and then exported to IBM SPSS Statistics 20.0 for analysis. Demographic characteristics of respondents were described using descriptive statistics. Multivariate logistic regression was conducted to determine the association between individual characteristics and KAP. Pearson's correlation coefficient was used to determine the association between knowledge-attitude, attitude-practice, and knowledge-practice. Statistical significance was determined at the P-value < 0.05. Around half of the participants were female (50.3%). The majority of participants were between 22 to 37 years, unmarried, and belonged to the Brahmin/Chhetri ethnic group. This study demonstrated a significant gap in KAP. Only 15.2% of participants had good knowledge while 25.9% and 68.3% of participants exhibited good attitudes and practices respectively. Marital status (AOR = 3.32, CI: 1.32-8.34), third-year educational level (AOR = 3.59, CI:1.34-9.57), and fourth-year educational level (AOR = 4.93, CI:1.88-12.94) were significantly associated with knowledge regarding dengue. Age (AOR = 1.73, CI: 1.10-3.01) was significantly associated with preventive practice regarding dengue. None of the demographic or socio-economic characteristics of respondents was associated with attitude on dengue. The knowledge-attitude (rka = 0.01), knowledge-practice (rkp = 0.22), and attitude-practice (rap = 0.01) were positively correlated in this study.

Knowledge, attitudes, and practices related to dengue among public school teachers in a Central Luzon Province in the Philippines: an analytic cross-sectional study

BACKGROUND

Dengue has become a major health issue in tropical regions as the numbers of reported cases and estimated infections continuously increase. In the Philippines, many challenges remain in preventing and controlling the disease amidst all the mitigation efforts of the government. This study sought to measure the health literacy of Filipino teachers and determine the associations among teachers' knowledge, attitudes, and selected practices (KAP) against dengue.

METHODS

Elementary and secondary school teachers from the consistently declared dengue hotspots in the City of San Fernando, Pampanga, Philippines, from the years 2017 to 2019 were selected as target participants in this cross-sectional study. A self-administered online survey tool was used in this study for both screening of participants and the KAP survey proper. STATA, descriptive statistics, and multiple logistic regression were used for the data analysis. Odds Ratios (ORs) and 95% confidence intervals (CIs) were reported.

RESULTS

The study comprised 604 participants whose mean age was 38.4 years. Television was determined as the top media source of information, and various health staff were the most trusted and common source of information. Good knowledge on dengue treatment (OR = 1.81; 95% CI 1.18-2.78) and dengue prevention (OR = 1.85; 95% CI 1.26-2.71) were positively associated with having good practices on protection against mosquito bites. Good knowledge on dengue signs and symptoms (OR = 1.56; 95% CI 1.02-2.37) and dengue prevention (OR = 2.38; 95% CI 1.59-3.58) were positively associated with having good practices on preventing breeding sites. Those with positive perceived susceptibility to dengue had lower odds of having good practices on protection against mosquito bites (OR = 0.64; 95% CI 0.41-0.99) and of having good practices on preventing breeding sites (OR = 0.46; 95% CI 0.26-0.81).

CONCLUSION

Even with the existing dengue policies, programs, and strategies, and the high disease literacy rate of Filipinos, dengue remains a struggle with an increasing case rate. Therefore, specific concepts should be emphasized, and interventions should be fine-tuned to better reach and influence the target population to attain a dengue-free Philippines.

Literacy and attitude of Asian youths on dengue and its prevention in an endemic developed community

Background

Over the past few decades, the incidence of dengue fever has considerably increased. Effective vector control strategies and specific protection using dengue vaccine are thought to be the key elements to combat dengue. The dengue incidence among the Singapore youths (15-24 years) was second only to that of adults (25-44 years). This study evaluated the knowledge and attitude of Singapore youths on dengue and its preventive measures.

Methods

A cross-sectional study using online-based questionnaire survey was conducted among Singapore youths from September to November 2022. Data were analyzed for descriptive statistics whereas Chi-squared test, linear regression analysis and Pearson correlation were used to determine the association between demographic factors and youth's attitude on dengue prevention using Rstudio.

Results

A total of 624 respondents completed the survey out of 1822 surveys distributed nation-wide, with a response rate of 34.2% (mean age 17.4 years ± 1.84; 59.3% female; 89.9% Chinese). The mean dengue knowledge scores of participants were 14.1 ± 2.8. Univariate analysis showed that teenagers (15-19 years) had significantly higher knowledge score than the young adults (20-24 years) (β =0.82,95%CI = 0.13-1.51, p = 0.021). Majority of them were aware of the Mozzie Wipeout campaign (90.2%) followed by the release of Wolbachia mosquitos (69.1%). Two-thirds of the youths who were aware of Wolbachia and Gravitrap considered that it was effective in reducing dengue infection rates. Participants suggested information about the current dengue infection rate (71.9%) as the most effective of the five proposed strategies to improve uptake of dengue preventive measures. In comparison to young adults, teenagers were more likely to uptake dengue preventive measures if widespread mosquito control practices were implemented (69.1% vs. 42.3%).

Conclusion

The overall knowledge of the youths on dengue and its prevention was satisfactory. Future health promotion campaigns targeting the youths should focus on transforming the knowledge into practice.

Assessing the basic knowledge and awareness of dengue fever prevention among migrant workers in Klang Valley, Malaysia

BACKGROUND

Globally, 390 million dengue virus infections occur per year. In Malaysia, migrant workers are particularly vulnerable to dengue fever (DF) due to mosquito breeding sites exposure and poor health literacy. Therefore, this study aimed to (i) assess the current DF knowledge, attitudes and practices (KAP), and (ii) identify strategies to promote DF awareness, among migrant workers in Klang Valley.

METHOD

A survey was conducted with 403 Nepali, Filipino and Indonesian migrant workers through phone interviews and online self-administered questionnaires. Piecewise structural equation modelling was applied to identify predictor variables for DF KAP.

RESULTS

Most respondents were male, working in the services industry, had completed high school, aged between 30-39 years and with less than ten years work experience in Malaysia. Overall, respondents' knowledge was positively correlated with attitude but negatively with practices. Older respondents, who had completed higher education, obtained higher knowledge scores. Similarly, those with working experience of >20 years in Malaysia obtained higher attitude scores. Respondents with a previous history of DF strongly considered the removal of mosquito breeding sites as their own responsibility, hence tended to frequently practise DF preventive measures. Respondents' knowledge was also positively correlated to their understanding of DF information sourced from social media platforms.

CONCLUSION

These findings highlighted: (i) the need for targeted DF educational intervention among younger and newly arrived workers with lower levels of education and (ii) maximising the usage of social media platforms to improve DF public awareness.

Societal knowledge, attitude, and practices towards dengue and associated factors in epidemic-hit areas: Geoinformation assisted empirical evidence

Dengue is one of Pakistan's major health concerns. In this study, we aimed to advance our understanding of the levels of knowledge, attitudes, and practices (KAPs) in Pakistan's Dengue Fever (DF) hotspots. Initially, at-risk communities were systematically identified via a well-known spatial modeling technique, named, Kernel Density Estimation, which was later targeted for a household-based cross-sectional survey of KAPs. To collect data on sociodemographic and KAPs, random sampling was utilized (n = 385, 5 % margin of error). Later, the association of different demographics (characteristics), knowledge, and attitude factors-potentially related to poor preventive practices was assessed using bivariate (individual) and multivariable (model) logistic regression analyses. Most respondents (>90 %) identified fever as a sign of DF; headache (73.8 %), joint pain (64.4 %), muscular pain (50.9 %), pain behind the eyes (41.8 %), bleeding (34.3 %), and skin rash (36.1 %) were identified relatively less. Regression results showed significant associations of poor knowledge/attitude with poor preventive practices; dengue vector (odds ratio [OR] = 3.733, 95 % confidence interval [CI ] = 2.377-5.861; P < 0.001), DF symptoms (OR = 3.088, 95 % CI = 1.949-4.894; P < 0.001), dengue transmission (OR = 1.933, 95 % CI = 1.265-2.956; P = 0.002), and attitude (OR = 3.813, 95 % CI = 1.548-9.395; P = 0.004). Moreover, education level was stronger in bivariate analysis and the strongest independent factor of poor preventive practices in multivariable analysis (illiterate: adjusted OR = 6.833, 95 % CI = 2.979-15.672; P < 0.001) and primary education (adjusted OR = 4.046, 95 % CI = 1.997-8.199; P < 0.001). This situation highlights knowledge gaps within urban communities, particularly in understanding dengue transmission and signs/symptoms. The level of education in urban communities also plays a substantial role in dengue control, as observed in this study, where poor preventive practices were more prevalent among illiterate and less educated respondents.

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.

Knowledge, attitude and practice (KAP) and risk factors on dengue fever among children in Brazil, Fortaleza: A cross-sectional study

BACKGROUND

Dengue fever is a mosquito-borne viral disease that is associated with four serotypes of the dengue virus. Children are vulnerable to infection with the dengue virus, particularly those who have been previously infected with a different dengue serotype. Sufficient knowledge, positive attitudes, and proper practices (KAP) are essential for dengue prevention and control. This study aims to estimate the dengue seropositivity for study participants and to examine the association between households' dengue-related knowledge, attitudes, and practices (KAP), and children's risk of dengue seropositivity, while accounting for socioeconomic and demographic differences in Brazil.

METHODOLOGY/PRINCIPAL FINDINGS

This analysis was based on a cross-sectional study from Fortaleza, Brazil between November 2019, and February 2020. There were 392 households and 483 participant children who provided a sample of sufficient quality for serological analysis. The main exposure was a household's dengue-related knowledge, attitudes, and practices, assessed through a questionnaire to construct a composite KAP score categorized into three levels: low, moderate, and high. The main outcome is dengue immunoglobulin G(IgG) antibodies, collected using dried blood spots and assessed with Panbio Dengue IgG indirect ELISA (enzyme-linked immunosorbent assays) test commercial kits. The estimated crude dengue seroprevalence among participating children (n = 483) was 25%. Five percent of households (n = 20) achieved a score over 75% for KAP, sixty-nine percent of households (n = 271) scored between 50% and 75%, and twenty-six percent of households (n = 101) scored lower than 50%. Each KAP domain was significantly and positively associated with the others. The mean percentage scores for the three domains are 74%, 63%, and 39% respectively. We found high household KAP scores were associated with an increased adjusted relative risk (aRR) of seropositivity (aRR: 2.11, 95% CI: 1.11-4.01, p = 0.023). Household adult respondents' education level of elementary school or higher was negatively associated with children's risk of being seropositive (aRR: 0.65, 95% CI: 0.48-0.87, p = 0.005). The risk of seropositivity in older children (6-12 years old) was over 6 times that of younger children (2-5 years old) (aRR: 6.08, 95% CI: 3.47-10.64, p<0.001). Children living in households with sealed water tanks or no water storage had a lower risk of being seropositive (aRR: 0.73, 95% CI: 0.54-0.98, p = 0.035).

CONCLUSIONS/SIGNIFICANCE

Our results provide insight into the prevalence of dengue seropositivity in Fortaleza, Brazil in children, and certain demographic and socioeconomic characteristics associated with children's risk of being seropositive. They also suggest that KAP may not identify those more at-risk for dengue, although understanding and enhancing households' KAP is crucial for effective community dengue control and prevention initiatives.

Effects of the source of information and knowledge of dengue fever on the mosquito control behavior of residents of border areas of Yunnan, China

BACKGROUND

Strengthening the mosquito control measures undertaken by residents of an area where dengue fever is present can significantly decrease the spread of this disease. The aim of this study was to explore the effects of the source of information and knowledge of dengue fever on the mosquito control behavior of residents of areas at high risk of this disease to determine effective ways of enhancing this behavior.

METHODS

A survey was conducted via face-to-face interviews or questionnaires between March and May 2021 in three regions of the province of Yunnan, China. The survey included basic information about the respondents, the source(s) of their dengue fever information, the level of their dengue fever knowledge, and the measures they had implemented to control mosquitoes. Principal component analysis was used to extract the main components of the sources of information. Correlation analysis and structural equation analysis were used to explore the impact of the sources of information and residents' dengue fever knowledge on their mosquito control behavior.

RESULTS

Publicity achieved through mass media, including official WeChat accounts, magazines/newspapers, poster leaflets, television/radio and the Internet, had a direct effect on dengue fever knowledge and mosquito control behavior, and indirectly affected mosquito control behavior through dengue fever knowledge. Organized publicity campaigns, including information provided by medical staff and through community publicity, had a direct effect on dengue fever knowledge and indirectly affected mosquito control behavior through dengue fever knowledge. The residents' level of dengue fever knowledge had a significant, positive, direct effect on their mosquito control behavior.

CONCLUSIONS

Mosquito control is an important measure for the prevention and control of outbreaks of dengue fever. An effective source of information can improve the level of dengue fever knowledge among residents and thus enhance their mosquito control behavior.

Effectiveness of dengue training programmes on prevention and control among high school students in the Yangon region, Myanmar

Background

Dengue is one of the health problems in Myanmar. Thus, health promotion in schools is considered a key approach for reducing risk-taking behaviours related to dengue.

Objectives

The study aimed to evaluate a dengue training programme for high school students to measure changes in knowledge, attitude and practices (KAP) towards dengue; evaluate the effectiveness of the programme in improving prevention and control practices among families and determining changes in larval indices in their dwelling places.

Methodology

The dengue school training programme was conducted for Grades 9 and 10 students in Yangon. In total, 300 students in the intervention school received training and were compared with 300 students as control. KAP was assessed using a self-administered questionnaire, whereas larval and control practice surveys were conducted at the homes of both groups 3 months before and after the programme.

Results

The KAP scores of the intervention group increased after the programme. Moreover, the programme improved prevention and control practices and decreased the larval indices in the intervention group. Students from the same group with high scores in knowledge and self-reported practices were less likely to exhibit Aedes larval positivity in their residential areas.

Conclusion

This study demonstrated the impact of the dengue training programme on the KAP of students and short-term family larval control practices, which influenced household larval indices.

RNA interference to combat the Asian tiger mosquito in Europe: A pathway from design of an innovative vector control tool to its application

The Asian tiger mosquito Aedes albopictus is currently spreading across Europe, facilitated by climate change and global transportation. It is a vector of arboviruses causing human diseases such as chikungunya, dengue hemorrhagic fever and Zika fever. For the majority of these diseases, no vaccines or therapeutics are available. Options for the control of Ae. albopictus are limited by European regulations introduced to protect biodiversity by restricting or phasing out the use of pesticides, genetically modified organisms (GMOs) or products of genome editing. Alternative solutions are thus urgently needed to avoid a future scenario in which Europe faces a choice between prioritizing human health or biodiversity when it comes to Aedes-vectored pathogens. To ensure regulatory compliance and public acceptance, these solutions should preferably not be based on chemicals or GMOs and must be cost-efficient and specific. The present review aims to synthesize available evidence on RNAi-based mosquito vector control and its potential for application in the European Union. The recent literature has identified some potential target sites in Ae. albopictus and formulations for delivery. However, we found little information concerning non-target effects on the environment or human health, on social aspects, regulatory frameworks, or on management perspectives. We propose optimal designs for RNAi-based vector control tools against Ae. albopictus (target product profiles), discuss their efficacy and reflect on potential risks to environmental health and the importance of societal aspects. The roadmap from design to application will provide readers with a comprehensive perspective on the application of emerging RNAi-based vector control tools for the suppression of Ae. albopictus populations with special focus on Europe.

Dengue-Related Information Needs and Information-Seeking Behavior in Pakistan

This present study aims to examine the information needs and information-seeking behavior of Dengue-affected and non-affected people by exploring their information needs, resources used, and obstacles encountered. A structured questionnaire was used to collect data from 100 Dengue patients and 200 non-patients. The collected data were analyzed by applying descriptive and inferential statistics. The findings revealed that a majority of the respondents had information needs regarding nutritional options, best approaches to treatment, and expected benefits of treatment. They mostly sought information to keep themselves up-to-date and to prevent the disease. Television, Internet search engines, and social media outlets were frequently used information sources along with information-seeking from family and friends. Respondents with higher academic qualifications reported comparatively higher Dengue-related information needs. Moreover, age was a positive predictor of both their information needs and frequency of using health information sources. The findings will be helpful for healthcare providers to tailor Dengue awareness campaigns and prevention strategies according to the public needs and preferences.

Effectiveness of Dengue Awareness Calendar on Indigenous Population: Impact on Knowledge, Belief and Practice

BACKGROUND

Dengue is prevalent among the indigenous community due to impoverished living conditions near the forest fringe areas and lack of health awareness. The study aims to determine the effect of a dengue awareness calendar on knowledge, belief, and practices (KBP) among the indigenous population.

METHOD

A cross-sectional study was conducted in nine selected indigenous villages in Selangor, Malaysia. A dengue awareness calendar was distributed to the indigenous communities after pre-intervention. The KBP scores were compared between the pre-and post-intervention.

RESULT

A total of 609 paired responses were obtained. Knowledge, perceived severity, cues to action, self-efficacy, and prevention practices were significantly improved after the intervention (p > 0.00). Participants with primary (Odds Ratio (OR) 2.627; 95% CI 1.338-5.160) and secondary level education (OR 2.263; 95% Cl 1.126-4.550) reported a high increment in practices score. High increments in dengue knowledge scores (OR 2.190; 95% CI 1.521-3.757, p < 0.00) were significantly more likely to report a high increment in practices score. Housewives (OR 0.535; 95% Cl 0.289-0.950), perceived severity (OR 0.349; 95% CI 0.184-0.662), and perceived susceptibility (OR 0.474; 95% CI 0.286-0.785) were significantly less likely to report an increment in prevention practices score.

CONCLUSION

Findings inferred that the dengue awareness calendar significantly improved knowledge and practices. Our findings revealed the effectiveness of the dengue awareness calendar in dengue prevention among indigenous communities.

Knowledge, attitude and practices regarding dengue and its vector among medical practitioners in Malakand region, Pakistan

Abstract Dengue fever (DF) is increasingly recognized as one of the world’s major mosquito borne diseases and causes significant morbidity and mortality in tropical and subtropical countries. Dengue fever is endemic in most part of Pakistan and continues to be a public health concern. Knowledge, attitude and practices can play an important role in management of the disease. Current study was aimed to determine the level of knowledge, attitude and practices regarding dengue fever among health practitioners, to study the level of knowledge and attitude with preventive practices for dengue fever. A cross sectional study was carried out in medical practitioners of the four districts of Malakand region during October to November 2019. A pre-structured questionnaire was used to collect data from medical practitioners. Data was analyzed using Graph Pad version 5. Significant value was considered when less than 0.05 (at 95% confidence of interval). The results revealed that most of participants have seen dengue vector (62%), the media being the most quoted source of information. Nearly 81.2% participants were aware from transmission of dengue fever is by mosquito bite. Practices based upon preventive measures were found to be predominantly focused towards prevention of mosquito bites rather than elimination of breeding places. Although the knowledge regarding DF and mosquito control measure was quite high among the medical practitioners but this knowledge was not put into practice. Further studies are required to aware the people about dengue and its vector in order to get prevention and control.

A Comparative Study on Dengue-related Knowledge, Attitude, and Practice in Hotspot and Non-Hotspot Areas in Selangor

Dengue fever is a deadly vector-borne disease. Prevention strategies without specific drugs or vaccines emphasise community involvement in dengue vector control. Identifying dengue-related knowledge, attitudes, and behaviours is critical to developing more effective intervention strategies. A cross-sectional study compared the knowledge, attitudes, and practices on dengue in selected dengue hotspots and non-hotspot areas in Selangor, Malaysia. A self-administered questionnaire was distributed among 320 randomly selected residents. Data were analysed using an independent t-test and Spearman’s rank-order correlation. Despite having a good understanding of the dengue virus, most respondents (83.1%) from both hotspot and non-hotspot areas were unaware that a person could be infected with the virus more than once in their lifetime, and 62.8% agreed that dengue patients could recover without treatment. Most respondents (76.9%) agreed that buying mosquito repellent is a waste of money, and most reported not sleeping under the insecticide net at night (74.7%). Respondents from dengue hotspot areas had significantly higher attitude scores (32.00±4.60) compared to those of non-hotspot regions (28.78±5.51), t (307) = 5.674, <i>p</i><0.05. There was a significant positive correlation between knowledge and attitude scores (r_s=0.214, p<0.01), between knowledge and practices (r_s=0.563, p<0.01), and attitude and practices (r_s=0.374, p<0.01). In addition to the high levels of knowledge and practice, attitudes toward dengue must be improved to implement proper prevention measures.

Influence of public hesitancy and receptivity on reactive behaviours towards releases of male Wolbachia-Aedes mosquitoes for dengue control

Singapore, a highly urbanized Asian tropical country that experiences periodic dengue outbreaks, is piloting field releases of male Wolbachia-carrying Aedes aegypti mosquitoes with the aim of suppressing urban populations of the primary dengue vector Aedes aegypti. This study proposes and assesses a model to explain the roles of hesitancy and receptivity towards Project Wolbachia-Singapore in influencing reactive mosquito prevention behaviors (reactive behaviors) towards the release of Wolbachia-Aedes mosquitoes for residents living in the release sites. Interestingly, both hesitancy and receptivity predicted greater instances of reactive behaviors. The model also examines the roles of general knowledge about Wolbachia technology, perceived severity of mosquito bites, perceived density of mosquitoes, and social responsibility as predictors of hesitancy, receptivity, and reactive behaviors towards the release of Wolbachia-Aedes mosquitoes. Hesitancy towards the project mediated the effects of general knowledge, perceived severity of mosquito bites, and perceived density of mosquitoes on reactive behaviors towards the releases, although receptivity towards the project did not. Having less knowledge about Project Wolbachia-Singapore was associated with higher hesitancy towards the project and higher likelihood of performing reactive behaviors towards the releases. Individuals who perceive mosquito bites to be more severe and think that there are more mosquitoes in their living environments were also more likely to be hesitant about the project and practice reactive behaviors. However, both hesitancy and receptivity towards the project mediated the effect of social responsibility on reactive behaviors. Receptivity towards the project was driven by social responsibility, which was also associated with reduced hesitancy towards the project. Our findings suggest that, to address the hesitancy reported by a minority of participants, future outreach efforts should focus on strengthening the public's sense of social responsibility and on tailored education campaigns targeting groups with low levels of knowledge of the project.

Assessment of dengue virus threat to blood safety and community health: A single center study in northern Egypt

Background

The risk of transfusion transmitted dengue (DENV) is increasingly recognized and poses a risk to blood safety as well as spreading into non-immune communities.

Objectives

To determine dengue serological profile, environmental risk, knowledge, and preventive measures among blood donors in a national blood bank in northern Egypt.

Methods

A total of 500 blood donors were enrolled into this study between June and September 2018. Socio-demographic and medical data were collected using a predesigned questionnaire. Blood samples were screened for anti-DENV IgM, anti-DENV IgG and non-structural protein 1 antigen (DENV-NS1 antigen).

Results

History of past dengue exposure was identified in 10.2% of blood donors. No samples (0.0%) tested positive for anti-DENV IgG, IgM or NS1 antigen. At the time of blood donation, no individuals had any symptoms suggestive of a dengue-related illness. Dengue exposure strongly correlated with travel to the Kingdom of Saudi Arabia (KSA), Sudan and the El-Quseir outbreak area in Egypt. Knowledge of dengue and prevention methods was found to be substantially deficient, and the relatively higher level of knowledge among exposed donors did not translate into appropriate preventative measures.

Conclusions

Our risk assessment shows the impact of travel on DENV exposure and highlights its potential threat to disease spread in Egypt. Dengue awareness programs are urgently needed for effective prevention of transmission.

Dengue surveillance using gravid oviposition sticky (GOS) trap and dengue non-structural 1 (NS1) antigen test in Malaysia: randomized controlled trial

Dengue remains a major public threat and existing dengue control/surveillance programs lack sensitivity and proactivity. More efficient methods are needed. A cluster randomized controlled trial was conducted for 18 months to determine the efficacy of using a combination of gravid oviposition sticky (GOS) traps and dengue non-structural 1 (NS1) antigen for early surveillance of dengue among Aedes mosquito. Eight residential apartments were randomly assigned into intervention and control groups. GOS traps were placed at the intervention apartments weekly to trap Aedes mosquitoes and these tested for dengue NS1 antigen. When dengue-positive pool was detected, the community were notified and advised to execute protective measures. Fewer dengue cases were recorded in the intervention group than the control. Detection of NS1-positive mosquitoes was significantly associated with GOS Aedes index (r_s = 0.68, P < 0.01) and occurrence of dengue cases (r_s = 0.31, P < 0.01). Participants' knowledge, attitude, and practice (KAP) toward dengue control indicated significant improvement for knowledge (P < 0.01), practice (P < 0.01) and total scores (P < 0.01). Most respondents thought this surveillance method is good (81.2%) and supported its use nationwide. Thus, GOS trap and dengue NS1 antigen test can supplement the current dengue surveillance/control, in alignment with the advocated integrated vector management for reducing Aedes-borne diseases.

Knowledge, attitudes, and practices of Anopheles mosquito control through insecticide treated nets and community-based health programs to prevent malaria in East Sumba Island, Indonesia

With an estimated 241 million human cases and 627,000 deaths in 2020, malaria remains a significant and ongoing global health challenge. This study employs a qualitative approach to investigate knowledge, attitudes, and practices surrounding mosquito control and prevention methods in East Sumba Regency, Indonesia. While malaria is under control in much of Indonesia, transmission in Sumba Island remains high, with incidence as high as 500 per 1000 population in some areas. A qualitative study was undertaken to explore use of insecticide treated nets, (ITNs), traditional Sumbanese mosquito control methods, and the role of women, integrated health service posts, (posyandu) and community-based health workers (kaders) in combatting malaria and controlling mosquitoes. Focus group discussions (n = 7) were conducted in East Sumba Island stratified by urban/rural location and level of malaria transmission. Key informant interviews (n = 14) were conducted with religious leaders, health workers, and women's group leaders. Results indicate that environmental conditions, such as high temperatures, were common deterrents to regular ITN use. Furthermore, our results suggest that community embedded health workers, kaders, and health service posts, posyandu, play an important role in information dissemination related to mosquitoes and mosquito-borne diseases as well as the distribution and use of ITNs in East Sumba Island. The role of the posyandu and kaders could be expanded to improve malaria prevention by integration with educational campaigns, aiding ITN distributions, and malaria diagnosis and treatment. This study is the first to examine mosquito-borne disease-related knowledge, attitudes, and practices in East Sumba Island, Indonesia. Results could improve mosquito control and malaria prevention by providing insights into local knowledge of Anopheles mosquitoes and malaria as well. Tailoring mosquito control and malaria prevention strategies around local knowledge and perceptions is likely to be more acceptable and sustainable.

Mapping the spatial distribution of the dengue vector Aedes aegypti and predicting its abundance in northeastern Thailand using machine-learning approach

BACKGROUND

Mapping the spatial distribution of the dengue vector Aedes (Ae.) aegypti and accurately predicting its abundance are crucial for designing effective vector control strategies and early warning tools for dengue epidemic prevention. Socio-ecological and landscape factors influence Ae. aegypti abundance. Therefore, we aimed to map the spatial distribution of female adult Ae. aegypti and predict its abundance in northeastern Thailand based on socioeconomic, climate change, and dengue knowledge, attitude and practices (KAP) and/or landscape factors using machine learning (ML)-based system.

METHOD

A total of 1066 females adult Ae. aegypti were collected from four villages in northeastern Thailand during January-December 2019. Information on household socioeconomics, KAP regarding climate change and dengue, and satellite-based landscape data were also acquired. Geographic information systems (GIS) were used to map the household-based spatial distribution of female adult Ae. aegypti abundance (high/low). Five popular supervised learning models, logistic regression (LR), support vector machine (SVM), k-nearest neighbor (kNN), artificial neural network (ANN), and random forest (RF), were used to predict females adult Ae. aegypti abundance (high/low). The predictive accuracy of each modeling technique was calculated and evaluated. Important variables for predicting female adult Ae. aegypti abundance were also identified using the best-fitted model.

RESULTS

Urban areas had higher abundance of female adult Ae. aegypti compared to rural areas. Overall, study respondents in both urban and rural areas had inadequate KAP regarding climate change and dengue. The average landscape factors per household in urban areas were rice crop (47.4%), natural tree cover (17.8%), built-up area (13.2%), permanent wetlands (21.2%), and rubber plantation (0%), and the corresponding figures for rural areas were 12.1, 2.0, 38.7, 40.1 and 0.1% respectively. Among all assessed models, RF showed the best prediction performance (socioeconomics: area under curve, AUC = 0.93, classification accuracy, CA = 0.86, F1 score = 0.85; KAP: AUC = 0.95, CA = 0.92, F1 = 0.90; landscape: AUC = 0.96, CA = 0.89, F1 = 0.87) for female adult Ae. aegypti abundance. The combined influences of all factors further improved the predictive accuracy in RF model (socioeconomics + KAP + landscape: AUC = 0.99, CA = 0.96 and F1 = 0.95). Dengue prevention practices were shown to be the most important predictor in the RF model for female adult Ae. aegypti abundance in northeastern Thailand.

CONCLUSION

The RF model is more suitable for the prediction of Ae. aegypti abundance in northeastern Thailand. Our study exemplifies that the application of GIS and machine learning systems has significant potential for understanding the spatial distribution of dengue vectors and predicting its abundance. The study findings might help optimize vector control strategies, future mosquito suppression, prediction and control strategies of epidemic arboviral diseases (dengue, chikungunya, and Zika). Such strategies can be incorporated into One Health approaches applying transdisciplinary approaches considering human-vector and agro-environmental interrelationships.

Knowledge, awareness and preventive practices of dengue outbreak in Bangladesh: A countrywide study

Background

Dengue, the mosquito borne disease has become a growing public health threat in Bangladesh due to its gradual increasing morbidity and mortality since 2000. In 2019, the country witnessed the worst ever dengue outbreak. The present study was conducted to characterize the socio-economic factors and knowledge, attitude and practice (KAP) status towards dengue among the people of Bangladesh.

Method

A cross-sectional study was conducted with 1,010 randomly selected respondents from nine different administrative regions of Bangladesh between July and November 2019.

A structured questionnaire was used covering socio-demographic characteristics of the participants including their knowledge, awareness, treatment and practices regarding dengue fever. Factors associated with the knowledge and awareness of dengue were investigated separately, using multivariable logistic regression.

Results

Although majority (93.8%) of the respondents had heard about dengue, however, they had still misconceptions about Aedes breeding habitat. Around half of the study population (45.7%) had mistaken belief that Aedes can breed in dirty water and 43.1% knew that Aedes mosquito usually bites around sunrise and sunset. Fever indication was found in 36.6% of people which is the most common symptom of dengue. Among the socio-demographic variables, the level of education of the respondents was identified as an independent predictor for both knowledge (p<0.05) and awareness (p<0.05) of dengue. The preventive practice level was moderately less than the knowledge level though there was a significant association (p<0.05) existed between knowledge and preventive practices. Our study noted that TV/Radio is an effective predominant source of information about dengue fever.

Conclusion

As dengue is emerging in Bangladesh, there is an urgent need to increase health promotion activities through campaigns for eliminating the misconception and considerable knowledge gaps about dengue.

Factors associated with dengue prevention behaviour in riverbank area: A cross-sectional study

Introduction

Dengue has been a burden, especially in tropical country. Indonesian Ministry of Health promote dengue prevention through environmental control with 3 M (covering water storage, cleaning water storage, and recycling unused items) practices. Here we analyzed factors associated with dengue prevention behavior in riverbank area of Yogyakarta Province.

Methods

The study employed cross-sectional survey covering riverbank area of Sendowo, Yogyakarta Province. This study systematically sampled 1 representative from every household to describe the condition of 1 house. We analyzed the associations between subjects' characteristics and dependent variables using Pearson's chi-square test.

Results

Overall, 89 subjects were enrolled in this study, of whom 11.2% males and 88.8% females. Age and occupation were associated with covering water storage variable with p-value of <0.001 and 0.007, respectively. Recycling unused items variable was associated with monthly income with p-values of 0.045. Furthermore, there were no significant associations between cleaning water storage variable with sex, age, marital status, education level, monthly income, and occupation.

Conclusion

Age and occupations were associated with covering water storage variable. Recycling unused items variable shows significant association with income. Further multiarea study is necessary to compare our findings with other areas.

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Dengue has been a burden in tropical country

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Several factors associated with dengue prevention behavior in riverbank area

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It is essential to promote dengue prevention through environmental control

Different Domains of Dengue Research in Malaysia: A Systematic Review and Meta-Analysis of Questionnaire-Based Studies

This review provided a systematic overview of the questionnaire-related dengue studies conducted in Malaysia and evaluated their reliability and validity used in the questionnaires. An extensive literature search was conducted using various electronic databases, including PubMed, EMBASE, Medline, and ScienceDirect. Systematic reviews and meta-analysis (PRISMA) were selected as the preferred item reporting method. Out of 88 identified dengue-related, 57 published from 2000 to April 2020 met the inclusion criteria and were included. Based on the meta-analysis, a poor mean score was obtained for knowledge (49%), attitude (44%), and preventive practice (55%). The study showed that the level of knowledge on cardinal signs and modes of transmission for dengue virus were highest among health care workers, followed by students (international and local) and lastly community residents. In treatment-seeking behaviours, only half of the respondents (50.8%) would send their child to the nearest health clinics or hospitals when a child became restless or lethargic. The acceptance rate for dengue vaccine, bacteria (Wolbachia), as a vector for dengue control and self-test diagnostic kit for dengue showed considerably high (88.4%, 70%, and 44.8%, respectively). Health belief model (HBM) constructs, such as perceived barriers, perceived severity, perceived susceptibility, self-efficacy, and perceived benefit influence prevention practices. Lastly, only 23 articles (40.3%) had piloted or pretested the questionnaire before surveying, in which three reported Cronbach's alpha coefficient (0.70-0.90). A need for active participation of communities and healthcare personnel, promotion of awareness, and safe complementary medicines, as well as assessment of psychometric properties of questionnaire use in dengue surveys in Malaysia, in order for assessing dengue reliably and valid.

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.

Knowledge, attitudes, and practices on climate change and dengue in Lao People's Democratic Republic and Thailand

BACKGROUND

Dengue is linked with climate change in tropical and sub-tropical countries including the Lao People's Democratic Republic (Laos) and Thailand. Knowledge about these issues and preventive measures can affect the incidence and outbreak risk of dengue. Therefore, the present study was conducted to determine the knowledge, attitudes, and practices (KAP) among urban and rural communities and government officials about climate change and dengue in Laos and Thailand.

METHODS

A cross-sectional KAP survey about climate change and dengue were conducted in 360 households in Laos (180 urban and 180 rural), 359 households in Thailand (179 urban and 180 rural), and 20 government officials (10 in each country) using structured questionnaires. Data analysis was undertaken using descriptive methods, principal component analysis (PCA), Chi-square test or Fisher's exact test (as appropriate), and logistic regression.

RESULTS

Significant differences among the selected communities in both countries were found in terms of household participant's age, level of education, socioeconomic status, attitude level of climate change and KAP level of dengue (P < 0.05; 95% CI). Overall, participants' KAP about climate change and dengue were low except the attitude level for dengue in both countries. The level of awareness among government officials regarding the climatic relationship with dengue was also low. In Lao households, participants' knowledge about climate change and dengue was significantly associated with the level of education and socioeconomic status (SES) (P < 0.01). Their attitudes towards climate change and dengue were associated with educational level and internet use (P < 0.05). Householders' climate change related practices were associated with SES (P < 0.01) and dengue related practices were associated with educational level, SES, previous dengue experience and internet use (P < 0.01). In Thailand, participants' knowledge about climate change was associated with the level of education and SES (P < 0.01). Their attitudes towards climate change were associated with residence status (urban/rural) and internet use (P < 0.05); climate change related practices were associated with educational level and SES (P < 0.05). Dengue related knowledge of participants was associated with SES and previous dengue experience (P < 0.05); participants' dengue related attitudes and practices were associated with educational level (P < 0.01).

CONCLUSION

The findings call for urgently needed integrated awareness programs to increase KAP levels regarding climate change adaptation, mitigation and dengue prevention to improve the health and welfare of people in these two countries, and similar dengue-endemic countries.

Knowledge, attitude and prevention practices of garment factory workers regarding the largest Dengue outbreak on record in Bangladesh

The aim of this cross-sectional study was to assess the knowledge, attitudes and prevention practices (KAP) among the garment factory worker population in Bangladesh regarding a historical dengue outbreak in 2019. A total of 400 participants were selected by simple random sampling, and questionnaire-based interviews were conducted. The average score of knowledge, attitude and prevention practice was 8.33 ± 2.35, 6.32 ± 1.20 and 6.31 ± 1.50, respectively. Only 76 out of 400 participants (19%) scored above 10 (all university-educated). Participant workers reported both negative and positive attitudes regarding dengue fever (DF). Negative attitudes included an expectation of increased mortality and strained family finances from DF attacks. A significantly high number of participants (92%) believed that death from DF was inevitable. Positive attitudes included optimism about DF eradication potentials and eagerness to help and donate blood to sick relatives. Participants primarily learned about the DF prevention from mass media (244/400; 61.0%) and social media (97/400; 24.25%). The most popular prevention measures adopted were mosquito repellent incense (344/400; 86.0%) and mosquito nets (389/400; 97.25%). While most participants (358/400; 89.5%) cleaned areas where mosquitos lay eggs, only 169 out of 400 (42.25%) regularly treated with chemical sprays. Only 182 out of 400 (45.5%) reported receiving DF prevention training in the factory. Correlation between DF knowledge and education was statistically significant (r = .38, p < .01, n = 398). Correlation between DF knowledge and work experience was insignificant (r = .01, p > .01, n = 398). Age and DF knowledge were not correlated (r = 0.07, p > .01, n = 398). In conclusion, gaps in KAP for dengue could be addressed by government-sponsored educational programmes that utilize the power of mass/social media for dengue prevention and control. More KAP surveillance studies are needed for other sectors of the society.

Knowledge, attitude and practice on dengue prevention and dengue seroprevalence in a dengue hotspot in Malaysia: A cross-sectional study

Dengue has become a global public health problem. Despite reactive efforts by the government in Malaysia, the dengue cases are on the increase. Adequate knowledge, positive attitude and correct practice for dengue control are essential to stamp out the disease. Hence, this study aims to assess the factors associated with dengue knowledge, attitude and practice (KAP), as well as the association with dengue IgM and IgG seropositivity. A community-based cross-sectional study was conducted in a closed, dengue endemic area with multi-storey dwellings . Five hundred individuals (aged 18 years and above) were approached for pre-tested KAP and seroprevalences assessment. The study showed only half of the total participants have good knowledge (50.7%) but they had insufficient knowledge about dengue during pregnancy. 53.2% of people had poor attitude and 50.2% reported poor practice for dengue control. Out of 85 respondents who agreed to participate in the dengue seroprevalence study, 74.1% (n = 63) were positive for dengue IgG and 7.1% (n = 6) were positive for dengue IgM. Among all sociodemographic variable, race is the only independent predicator for all KAP levels (P < 0.05). In conclusion, proactive and sustainable efforts are needed to bring a behavioural change among communities in order to fight dengue outbreaks in endemic areas.

Survey of Dengue Knowledge and Prevention Practices Associated with Sociodemographic Status: A Cross-Sectional Study Among the Community Living in an Urban Area of Selangor, Malaysia

The present study aimed to explore the current status of knowledge and practices of dengue prevention associated with sociodemographic status among the community living in an urban area of Selangor, Malaysia. A total of 441 participants were interviewed regarding sociodemographic status, knowledge of dengue, and self-reported prevention practices. Participants over 40 years old were more likely (odds ratio [OR] = 4.210, 95% CI = 1.652-10.733, P = 0.003) to have better dengue knowledge. Participants whose average monthly household income was more than MYR3,000 (US$715) were more likely (OR = 1.607, 95% CI = 1.059-2.438, P = 0.026) to have better practices of dengue prevention measures. The finding suggests that both government and community efforts are essential in order to continue to educate about dengue and reduce the frequency of dengue cases nationwide.

Dengue fever among febrile patients in Taiz City, Yemen during the 2016 war: Clinical manifestations, risk factors, and patients knowledge, attitudes, and practices toward the disease

The current war in Yemen has displaced millions of people from their homes into living in cramped shelters where the healthcare is limited. The breakdown of Yemen's healthcare and sanitation systems has facilitated the spread of infectious diseases including mosquito-borne diseases. The present study aimed to describe the prevalence of dengue virus (DENV) infection among the febrile patients of the Taiz governorate, Yemen as well as their knowledge, attitude and preventive practices (KAPs) regarding dengue fever (DF), and to investigate the factors associated with dengue preventive practices during the war. A total of 384 clinically dengue-suspected patients who sought health care in Taiz, Yemen during the period from July 2016 until October 2016 were recruited for the study. Serum samples were obtained and screened for the presence of DENV RNA and anti-DENV antibodies by reverse transcription-recombinase polymerase amplification (RT-RPA) and dengue IgM/IgG-capture ELISA, respectively. KAP questionnaires were obtained from all participants too. In the study, dengue was laboratory confirmed in approximately 49.3% (189/384) of the clinically suspected dengue patients. In general, 67.1% of the patients had low knowledge scores regarding DF. Low scores for knowledge about DF was significantly associated with those in the age groups of ≤20 years and 21-30 years, illiterates and patients with non-skilled jobs or jobless. The most common preventive practices reported by participants were covering stored water (78.6%) and putting a screen on the house's windows (65.3%). A low proportion of participants (6.7%) had 51-100% of good DF preventive practices. Low scores of positive attitudes toward DF was identified as a risk factor. The study participants showed poor knowledge about DF and their ways of dealing with the various aspects of DF prevention was quite limited, hence, preventive measures against the disease were less likely to be undertaken. Findings from the study highlight the peril of dengue in Taiz, Yemen, which is now comparable to that of endemic regions. The ongoing civil war with disruption in regular health services compounded by the low knowledge about DF as well as the limited DF preventive practices could result in entrenchment of dengue in Yemen.

Understanding the role of disease knowledge and risk perception in shaping preventive behavior for selected vector-borne diseases in Guyana

BACKGROUND

Individual behavior, particularly choices about prevention, plays a key role in infection transmission of vector-borne diseases (VBDs). Since the actual risk of infection is often uncertain, individual behavior is influenced by the perceived risk. A low risk perception is likely to diminish the use of preventive measures (behavior). If risk perception is a good indicator of the actual risk, then it has important implications in a context of disease elimination. However, more research is needed to improve our understanding of the role of human behavior in disease transmission. The objective of this study is to explore whether preventive behavior is responsive to risk perception, taking into account the links with disease knowledge and controlling for individuals' socioeconomic and demographic characteristics. More specifically, the study focuses on malaria, dengue fever, Zika and cutaneous leishmaniasis (CL), using primary data collected in Guyana-a key country for the control and/or elimination of VBDs, given its geographic location.

METHODS AND FINDINGS

The data were collected between August and December 2017 in four regions of the country. Questions on disease knowledge, risk perception and self-reported use of preventive measures were asked to each participant for the four diseases. A structural equation model was estimated. It focused on data collected from private households only in order to control for individuals' socioeconomic and demographic characteristics, which led to a sample size of 497 participants. The findings showed evidence of a bidirectional association between risk perception and behavior. A one-unit increase in risk perception translated into a 0.53 unit increase in self-reported preventive behavior for all diseases, while a one-unit increase in self-reported preventive behavior (i.e. the use of an additional measure) led to a 0.46 unit decrease in risk perception for all diseases (except CL). This study also showed that higher education significantly improves knowledge and that better knowledge increases the take up of preventive measures for malaria and dengue, without affecting risk perception.

CONCLUSIONS

In trying to reach elimination, it appears crucial to promote awareness of the risks and facilitate access to preventive measures, so that lower risk perception does not translate into lower preventive behavior.

School-based health education for dengue control in Kelantan, Malaysia: Impact on knowledge, attitude and practice

The massive flood in Malaysia’s east coast in December 2014 has placed Kelantan in a possible dengue outbreak risk. At this point, community awareness is essential in preventing disease spread. However, no data on knowledge, attitude, and practice (KAP) of dengue in Kelantan have existed in relevance to flood disaster, although such information is necessary for the vector control programs. The purpose of this study is to assess the KAP regarding dengue among school children from flooded and unflooded areas and to evaluate the effectiveness of the dengue health education program in improving their KAP level. A school-based pre- and post-tests design was utilized in this study whereby a booklet on dengue was distributed during the interphase of the tests. The information collected was on the socio-demographic, KAP and the source of dengue information. We statistically compared the KAP between the two study sites and the pre- and post-test scores to evaluate the health education program. A total of 203 students participated in the survey, and 51.7% of them were flood victims. When comparing the baseline KAP, the respondents from the unflooded area had higher knowledge scores compared to those from the flooded area (P<0.05), while non-significant differences were observed in the attitude and practice between the two study areas (P>0.05). The health education program significantly improved knowledge and practice in the flooded area and knowledge only in the unflooded area (P<0.05). The multinomial regression analysis suggests that age and dengue history are the primary determinants that influence the high practice level in both areas. We suggest the need to increase routine dengue health education programs to all age groups targeting both high and low dengue risk areas, and the necessity to ensure the translation of positive knowledge and attitude changes into real dengue preventive practices.

The KAP research design is widely used in diagnosing the current awareness of any diseases and to evaluate the efficiency of any health-related treatments or intervention programs. Until date, such KAP assessment and health education programs regarding dengue in the disaster-affected region are relatively rare, especially in Malaysia. Providing health education to the community is as important as other vector control strategies such as source reduction and insecticide spraying because none of these will be successful without community involvement is disease prevention. The massive flood that struck the east coast region of Malaysia poses a possible threat in Kelantan for dengue transmission. Dengue KAP assessment associated with health education for the community at risk is essential to find the gaps in the community and also to ensure their understanding in vector biology, disease spread mechanisms and key behaviors that need to be adopted in order to prevent the spread of dengue. The study provides useful content and knowledge that could guide local authorities and health officials to plan and execute health education programs to disaster-affected populations and also unaffected populations to prevent and control dengue.

New Methodologies for Global Health Research: Improving the Knowledge, Attitude, and Practice Survey Model Through Participatory Research in Haiti

Knowledge, attitude, and practice (KAP) survey models are a common tool used by researchers and global health practitioners to reveal insights necessary for health program design and implementation. We explore how an interdisciplinary team of medical practitioners, researchers, designers, and community members improved the KAP survey tool in Haiti by drawing on participatory research methods. The overall objective of the project was to build a new approach to investigating and meeting community health needs and specifically the challenges faced by women with breast and cervical cancer in Haiti. The research findings were used to design an education tool kit for health care providers as well as create a community-based engagement strategy to better connect people to cancer screening and treatment facilities. By infusing the KAP survey model with participatory approaches to knowledge production, the advisory board designed a survey tool that generated more relevant and in-depth knowledge with the community while maintaining the study's simplicity and complying with a time-limited budget.

Knowledge, attitude and practice towards dengue fever prevention and associated factors among public health sector health-care professionals: in Dire Dawa, eastern Ethiopia

Background: The Ethiopian national strategy for the prevention, control and elimination of malaria is one of the Health Development Programs (HDP IV). Dengue fever is one of the vector borne diseases that causes Acute Febrile Illness and death in tropical and sub-tropical countries. Knowledge, attitude and practice of health-care professionals towards dengue fever prevention and associated factors among health professionals is not yet well known across the country and concern is varied in context and place. Therefore, the aim of this research was to assess knowledge, attitude and practice towards dengue fever prevention and associated factors among public health sector health-care professionals in Dire Dawa administrative city, eastern Ethiopia.

Materials and methods: An Institution-based cross sectional study was conducted from September 9 to October 13, 2017. The study was conducted among a sample of 348 health-care professionals which were from the randomly selected nine clusters of public health facilities located in urban and rural areas of Dire Dawa. Data were collected by self-administered structured questionnaire. Bivariate and multinomial logistic regression analyses were made to check the associations among predictor variables and to control for confounding factors. A P-value <0.05 was used to declare statistical significance.

Results: Of the 348 sampled health-care professionals, 300 were included in the analysis giving a response rate of 86.2%. Nearly half (148/49.3%) of the participants demonstrated a moderate level of knowledge, 140 (46.7%) a neutral level of attitude and 156 (52%) a low level of practice towards dengue fever prevention. Multinomial logistic regression revealed that type of health profession, type of health facility and dengue fever prevention training status were significantly associated with the knowledge, attitude and practice of health-care professionals. The odds of physicians and public-health officers having a high level of knowledge or a low knowledge level were (AOR [95% CI] =38.793 [7.279, 206.734]) and (AOR[95% CI] =6.15[1.643, 23.026]) times higher than the odds for nurse professionals. The odds for professionals who worked in health centers and had a high knowledge level towards dengue fever prevention were (AOR [95% CI] =0.252 [0.086, 0.737]) times higher than those working in referral hospitals. The odds of health-care professionals who were public-health officers and those who worked in primary hospitals having a favorable attitude towards dengue fever prevention were (AOR [95% CI] =7.011 [1.867, 26.321]) and (AOR [95% CI] =3.683 [1.284, 10.563]) times higher than the odds for nurse professionals and those who worked in a referral hospital setting respectively. The odds of health-care professionals who took dengue fever prevention training were 10.23 times (AOR [95% CI] =10.23 [1.052, 99.478]) higher than the odds for health-care professionals who had not received the training.

Conclusion: Knowledge attitude and practice of health-care professionals were not satisfactory towards dengue fever. Additional training is required to plug this gap. Thus, the regional health bureau and stakeholders should follow up and provide support including provision of the World Health Organization’s standardized guidelines of dengue fever prevention. We recommend similar studies to be done specifically in Ethiopia and elsewhere to better understand the gaps.

Knowledge, Attitude and Practice about Dengue Fever among Patients Experiencing the 2017 Outbreak in Vietnam

There is a gap in the literature on the understanding of the general Vietnamese population toward dengue fever (DF). This study aimed to explore knowledge, attitudes, practice (KAP) of dengue fever among Vietnamese participants and the potential associated factors. A cross-sectional study was conducted among 330 patients at the Bach Mai Hospital in Northern Vietnam. A Tobit regression model was utilized to investigate the associated factors. The average knowledge score was 4.6/19. Respondents perceived their risk of DF infection to be very low (39.5%) to low (20.7%) and had a neutral attitude about the necessity of hospitalization when being infected with DF (60.9%). A total of 17.6%, 9.8% and 6.6% of respondents reported frequently changing water, properly disposing of waste and covering water storage containers to eliminate larvae. Gender, education level, duration of illness and travel history were correlated with knowledge. Occupation, the presence of DF in the neighborhood, mosquito density at home and DF symptom severity were associated with attitudes. Occupation, mosquito density at home, type of patient, knowledge and attitudes were associated with practices. To enhance the KAP towards DF, further efforts should first be directed to improve knowledge through education, especially at the school level and people in less developed areas.

Public perception and attitude towards dengue prevention activity and response to dengue early warning in Malaysia

An early warning system for dengue is meant to predict outbreaks and prevent dengue cases by aiding timely decision making and deployment of interventions. However, only a system which is accepted and utilised by the public would be sustainable in the long run. This study aimed to explore the perception and attitude of the Malaysian public towards a dengue early warning system. The sample consisted of 847 individuals who were 18 years and above and living/working in the Petaling District, an area adjacent to Kuala Lumpur, Malaysia. A questionnaire consisting of personal information and three sub-measures of; i) perception, ii) attitude towards dengue early warning and iii) response towards early warning; was distributed to participants. We found that most of the respondents know about dengue fever (97.1%) and its association with climate factors (90.6%). Most of them wanted to help reduce the number of dengue cases in their area (91.5%). A small percentage of the respondents admitted that they were not willing to be involved in public activities, and 64% of them admitted that they did not check dengue situations or hotspots around their area regularly. Despite the high awareness on the relationship between climate and dengue, about 45% of respondents do not know or are not sure how this can be used to predict dengue. Respondents would like to know more about how climate data can be used to predict a dengue outbreak (92.7%). Providing more information on how climate can influence dengue cases would increase public acceptability and improve response towards climate-based warning system. The most preferred way of communicating early warning was through the television (66.4%). This study shows that the public in Petaling District considers it necessary to have a dengue warning system to be necessary, but more education is required.

Knowledge, Attitudes, and Practices regarding Severe Fever with Thrombocytopenia Syndrome in Endemic Areas of Anhui Province, Eastern China

This study aimed to assess baseline knowledge, attitudes, and practices about severe fever with thrombocytopenia syndrome (SFTS) and identify the target population for health education programs in endemic areas of Anhui, China. This cross-sectional study was conducted from May to June 2017. Of 752 participants, 383 (50.9%) were from Nanqiao District, 397 (52.8%) were female, and 430 (57.2%) were farmers; 37.4% had heard about SFTS, but knowledge of symptoms and signs including fever (34.2%), leukopenia (8.0%), and thrombocytopenia (10.1%) was low. Only 12.1% knew that SFTS virus is transmitted by ticks, 9.4% realized that the blood and body fluid of SFTS are infectious, and only 38.2% thought that the tick should be paralyzed using medical alcohol or iodine. Meanwhile, 61.3% wore long-sleeve clothes, whereas 20.2% used repellents. Median scores for knowledge, attitudes, and practices, and the total score were 4.0, 6.0, 5.0, and 16.0, respectively. Knowledge was influenced by region (OR = 0.632, 95% CI: 0.399-0.999), education (OR = 0.516, 95% CI: 0.434-0.612), gender (OR = 1.865, 95% CI: 1.165-2.987), and age (OR = 3.406, 95% CI: 2.345-4.947). Education was a predictor of lack of appreciation of infection risk (OR = 0.519, 95% CI: 0.449-0.599) and practice (OR = 0.481, 95% CI: 0.396-0.584). Our findings indicate that SFTS-related health education programs are required for females; participants from Qianshan Prefecture; those with an occupation of farmer, retiree, houseworker, or unemployed; elderly participants; and those with low education. Large-scale sustainable health education programs focusing on the target populations are urgently needed in endemic areas.

Socioeconomic and demographic predictors of resident knowledge, attitude, and practice regarding arthropod-borne viruses in Panama

Background

We sought to identify if socioeconomic and demographic factors play a role in resident knowledge, attitude, and practice regarding Dengue, Chikungunya, and Zika in order to inform effective management procedures for disease prevention in Panama, a middle-income tropical country in Central America. All three are arthropod-borne viruses transmitted by Aedes mosquito vectors present in the focal region of Panama City, the largest city in Central America and an urban region of extreme socioeconomic polarization.

Methods

Between November 2017 and February 2018, we administered standardized, anonymous knowledge, attitude, and practice surveys to 263 residents split between two neighborhoods of high socioeconomic status (SES) and two neighborhoods of low SES. We then summed the knowledge, attitude, and practice scores respectively, and used linear and logistic regressions to quantify relationships with socioeconomic and demographic factors.

Results

Low-SES neighborhoods with high proportions of low income residents, residents over 70 years old had lower mean knowledge scores compared to other groups. Furthermore, residents in neighborhoods of low SES reported more mosquito biting relative to residents in neighborhoods of high SES, yet comparably lower level of concerns for disease transmission. Additionally, knowledge was lower for the more novel emergent threats of Chikungunya and Zika, compared to the endemic Dengue.

Conclusion

Findings suggest that low-SES neighborhoods with high proportions of low income, low education, and elderly residents should be targeted for outreach programs designed to prevent DENV, CHIKV, or ZIKV in Panama City. These outcomes support our initial hypotheses as lower relative knowledge and fewer practices related to the prevention of Dengue, Chikungunya, and Zika were found in low-SES neighborhoods. There is also a widespread lack of adequate knowledge regarding these diseases as well as low levels of concern in areas of highly reported mosquito biting. We provide suggestions for taking neighborhood socioeconomic status and specific aspects resident health literacy and attitude into account for creating more effective outreach campaigns as both endemic and novel arthropod-borne disease rates continue to increase throughout Latin America.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6172-4) contains supplementary material, which is available to authorized users.

A Novel Sampling Method to Measure Socioeconomic Drivers of Aedes Albopictus Distribution in Mecklenburg County, North Carolina

Climate change, urbanization, and globalization have facilitated the spread of Aedes mosquitoes into regions that were previously unsuitable, causing an increased threat of arbovirus transmission on a global scale. While numerous studies have addressed the urban ecology of Ae. albopictus, few have accounted for socioeconomic factors that affect their range in urban regions. Here we introduce an original sampling design for Ae. albopictus, that uses a spatial optimization process to identify urban collection sites based on both geographic parameters as well as the gradient of socioeconomic variables present in Mecklenburg County, North Carolina, encompassing the city of Charlotte, a rapidly growing urban environment. We collected 3,645 specimens of Ae. albopictus (87% of total samples) across 12 weeks at the 90 optimized site locations and modelled the relationships between the abundance of gravid Ae. albopictus and a variety of neighborhood socioeconomic attributes as well as land cover characteristics. Our results demonstrate that the abundance of gravid Ae. albopictus is inversely related to the socioeconomic status of the neighborhood and directly related to both landscape heterogeneity as well as proportions of particular resident races/ethnicities. We present our results alongside a description of our novel sampling scheme and its usefulness as an approach to urban vector epidemiology. Additionally, we supply recommendations for future investigations into the socioeconomic determinants of vector-borne disease risk.

Linking stormwater Best Management Practices to social factors in two suburban watersheds

To reduce nutrient pollution in urban watersheds, residents need to voluntarily practice a range of stormwater Best Management Practices (BMPs). However, little is known about the underlying social factors that may act as barriers to BMP implementation. The overall goal of this study was to better understand barriers to BMP implementation by exploring the links among resident demographics, knowledge, and behaviors so that appropriate education can be more effectively developed and targeted. In 2014–2015, a detailed questionnaire was administered door-to-door to 299 randomly selected households in two sub-watersheds of the Chesapeake Bay basin to test relationships among resident demographics, knowledge and attitudes towards water resources and BMPs, and BMP implementation. Multifactor regression models showed that respondents who had greater knowledge of water resources and BMPs lived in households that implemented greater numbers of BMPs. In turn, resident BMP knowledge, or familiarity with BMPs, strongly varied with race and ownership status, with respondents who identified as Caucasian or within a collection of ‘Other’ races, and who were home owners, having greater BMP knowledge than respondents who identified as African American and who were home renters, respectively. Renters and members of homeowner’s associations were also less likely to implement BMPs independent of knowledge, possibly reflecting perceived or real bureaucratic or procedural barriers to good stormwater management. Overall, respondents preferred to receive educational materials on stormwater via pamphlets and YouTube videos. These results suggest that resident ownership status knowledge is important to determining the number of household BMPs, and that education outreach should probably target African American and renting households that have lower BMP knowledge and landlords and administrators of homeowner’s associations using well-planned print and video educational media.

Prevalence of dengue fever virus antibodies and associated risk factors among residents of El-Gadarif state, Sudan

BACKGROUND

Dengue fever, caused by dengue virus (DENV), has become one of the most important mosquito-borne viral diseases with a steady rise in global incidence, including the Sudan. Sporadic cases and frequent acute febrile illness outbreaks, compatible with Dengue fever, have been reported in El-Gadarif State, Sudan. However, diagnosis was based almost exclusively on clinical signs without confirmatory laboratory investigations. Despite the magnitude of the problem in El-Gadarif State, no information is currently available with regard to the epidemiology of the disease in this State. El-Gadarif State is one of the largest commercial centers in the Sudan. The objective of the present investigation is to estimate the prevalence of DENV antibodies, and determine the potential risk factors associated with seropositivity among residents of El-Gadarif State.

METHODS

A cross sectional study was conducted in a total of 701residents randomly selected from all 10 localities in El-Gadarif State. The sera from the 701 residents were tested for the presence of DENV-specific immunoglobulin G (IgG) antibodies using a commercially available Anti-dengue IgG enzyme-linked immunosorbent assay (ELISA).

RESULTS

Among the 701 residents, 334 residents (47.6%) were seropositive for DENV. Mosquito control (OR = 2.73, CI = 1.37-5.87, p-value = 0.001); low income (OR = 2.31, CI: 1.71-6.36, p value = 0.032); sleeping out-doors (OR = 3.73, CI = 2.63-6.23, p-value = 0.013), and localities were determined as potential risk factors for contracting DENV infection.

CONCLUSIONS

The prevalence rate of DENV antibodies among residents of El-Gadarif State is significantly high (47.6%). Further epidemiologic studies including, distribution of mosquito vectors and implementation of improved surveillance are urgently warranted for better prediction and prevention of a possible DENV outbreak in El-Gadarif State, Sudan.

Factors associated with dengue prevention behaviour in Lowokwaru, Malang, Indonesia: a cross-sectional study

Background

Dengue prevention is important for controlling the spread of dengue infection. Transmission of dengue can be prevented by controlling mosquito breeding sites. Indonesia has dengue a prevention program to minimize mosquito breeding sites known as 3 M Plus. This study aimed to investigate factors associated with dengue prevention behaviour among respondents in the Lowokwaru subdistrict, an urban area in Malang, Indonesia.

Methods

This cross-sectional study used a semi-structured questionnaire that was conducted by face-to-face interview.

Results

Older respondents (> 60 years and 41–60 years) showed better dengue prevention behaviour than younger respondents (21–40 years and < 21 years) (p value = 0.01). Proportionally more male respondents showed poor dengue prevention behaviour compared with female respondents (p value = 0.007). Respondents who lived in Malang for long durations showed better dengue prevention behaviour compared with those who lived there for a shorter period (p value = 0.016). Those with more family members in their households practiced better dengue prevention behaviour compared with those with fewer family members (p value = 0.004). Perception was associated with dengue prevention behaviour. Respondents who had higher perceived susceptibility showed better dengue prevention behaviour compared with those who had moderate perceptions (p value = 0.000).

Conclusions

Age, gender, duration of stay in Malang, number of family members, and perception of dengue susceptibility were associated with dengue prevention behaviour.

Knowledge of Dengue Among Students Exposed to Various Awareness Campaigns in Model Schools of Islamabad: A Cross-Sectional Study

Objective

To determine the knowledge of dengue among school students exposed to various awareness campaigns in model schools of Islamabad.

Methods

We conducted a cross-sectional study of students who were studying in Islamabad Model School for Girls F-7/2 and Islamabad Model College for Boys F-7/3 from September 2017 to October 2017. Students in the ninth and tenth grades who were willing to participate in the study and who were studying in the school for more than six months were included in the study. The data was collected through a self-constructed questionnaire. Cronbach's alpha was used to assess the internal consistency of the questionnaire, and it was found to be 0.83. The data obtained was analyzed on IBM's statistical package for the social sciences (SPSS) version 21 (IBM, Armonk, NY).

Results

Out of 601 participants, 345 (57.4%) were males and 256 (42.6%) were females. The mean age of the participants was 14.72±1.09. About 380 participants (63.2%) were studying in the ninth grade and 221 participants (36.8%) were studying in the tenth grade. A majority of the participants (67.2%) had poor knowledge of dengue. The participants scored highest in knowledge of prevention of the dengue domain and scored the lowest in knowledge of transmission of dengue. A majority of the participants (72.9%) reported that they acquire knowledge about dengue fever through television and radio. About 44.60% of the participants reported that they acquired knowledge about dengue fever through awareness campaigns in school.

Conclusions

The knowledge of the students was found to be insufficient despite several awareness campaigns. There is a need to re-evaluate the structure of the awareness campaigns as they fail to reach their target. Electronic media was identified as the most useful source of knowledge, and its incorporation can help increase the effectiveness of awareness campaigns.

Knowledge, attitude, and practice regarding dengue virus infection among inhabitants of Aceh, Indonesia: a cross-sectional study

BACKGROUND

The Indonesian region of Aceh was the area most severely affected by the earthquake and tsunami of 26 December 2004. Department of Health data reveal an upward trend of dengue cases in Aceh since the events of the tsunami. Despite the increasing incidence of dengue in the region, there is limited understanding of dengue among the general population of Aceh. The aim of this study was to assess the knowledge, attitude, and practice (KAP) regarding dengue among the people of Aceh, Indonesia in order to design intervention strategies for an effective dengue prevention program.

METHODS

A community-based cross-sectional study was conducted in Aceh between November 2014 and March 2015 with a total of 609 participants living in seven regencies and two municipalities. Information on the socio-demographic characteristics of participants and their KAP regarding dengue was collected using a pre-tested structured questionnaire. The KAP status (good vs. poor) of participants with different socio-demographic characteristics was compared using Chi Square-test, ANOVA or Fisher's exact test as appropriate. Logistic regression analysis was used to determine the predictors of each KAP domain.

RESULTS

We found that 45% of participants had good knowledge regarding dengue and only 32% had good attitudes and good dengue preventive practices. There was a significant positive correlation between knowledge and attitudes, knowledge and practice, and attitudes and practice. In addition, people who had good knowledge were 2.7 times more likely to have good attitudes, and people who had good attitudes were 2.2 times more likely to have good practices regarding dengue. The level of education, occupation, marital status, monthly income, socioeconomic status (SES) and living in the city were associated with the knowledge level. Occupation, SES, and having experienced dengue fever were associated with attitudes. Education, occupation, SES and type of residence were associated with preventive practices.

CONCLUSION

Our study suggests that dengue prevention programs are required to increase KAP levels regarding dengue in the communities of Aceh.

Dengue knowledge, attitudes and practices and their impact on community-based vector control in rural Cambodia

BACKGROUND

Globally there are an estimated 390 million dengue infections per year, of which 96 million are clinically apparent. In Cambodia, estimates suggest as many as 185,850 cases annually. The World Health Organization global strategy for dengue prevention aims to reduce mortality rates by 50% and morbidity by 25% by 2020. The adoption of integrated vector management approach using community-based methods tailored to the local context is one of the recommended strategies to achieve these objectives. Understanding local knowledge, attitudes and practices is therefore essential to designing suitable strategies to fit each local context.

METHODS AND FINDINGS

A Knowledge, Attitudes and Practices survey in 600 randomly chosen households was administered in 30 villages in Kampong Cham which is one of the most populated provinces of Cambodia. KAP surveys were administered to a sub-sample of households where an entomology survey was conducted (1200 households), during which Aedes larval/pupae and adult female Aedes mosquito densities were recorded. Participants had high levels of knowledge regarding the transmission of dengue, Aedes breeding, and biting prevention methods; the majority of participants believed they were at risk and that dengue transmission is preventable. However, self-reported vector control practices did not match observed practices recorded in our surveys. No correlation was found between knowledge and observed practices either.

CONCLUSION

An education campaign regarding dengue prevention in this setting with high knowledge levels is unlikely to have any significant effect on practices unless it is incorporated in a more comprehensive strategy for behavioural change, such a COMBI method, which includes behavioural models as well as communication and marketing theory and practice.

TRIAL REGISTRATION

ISRCTN85307778.

Cross-Sectional Survey on the Dengue Knowledge, Attitudes and Preventive Practices Among Students and Staff of a Public University in Malaysia

Behavioural impact programmes are especially effective for dengue control and prevention. Universities are key settings for health promotion, so understanding factors that influence the practice of dengue prevention within a university community becomes important. This study aimed to examine the factors affecting dengue knowledge, attitude and preventive practices amongst students and staff of a public university. A cross-sectional survey study was conducted in Kuala Lumpur, Malaysia. A total of 372 students and staff of the NDUM were recruited by stratified sampling method. Data were collected via self-administered pre-tested structured questionnaires covering socio-demography and dengue KAP. Data were analysed descriptively. For bivariate analysis, Chi square test was applied. To explore the factors independently associated with the practice of dengue prevention, a logistic regression model was introduced. Overall, the participants had moderate dengue-related knowledge, good attitudes and good preventive practices. The majority had misconceptions about mosquito biting habits (83.8 %), seasonality of dengue epidemics (73.2 %), and mosquito breeding sites (70.3 %). Staff were more likely to have good dengue-related knowledge (p < 0.001) and attitudes (p = 0.008) than students. There was statistically significant positive association between the level of dengue knowledge and monthly average household income (p = 0.008), age (p < 0.001) and education (p < 0.001). Having good attitudes towards dengue was associated with being a non-Malay (p = 0.034), having higher monthly average household income (p = 0.047) and tertiary education (p < 0.001). In regression analysis, only dengue knowledge and dengue attitudes were significantly and positively associated with practice of dengue prevention. Dengue preventive strategies amongst university students and staff should focus on maintaining good dengue-related preventive practices. Educational campaigns should mainly target students, young staff members, and those with lower level of education and income.