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

ABSTRACT: 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.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.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.ISRCTN85307778.

SUBMITTER: Kumaran E

PROVIDER: S-EPMC5833285 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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

Kumaran Emmanuelle E Doum Dyna D Keo Vanney V Sokha Ly L Sam BunLeng B Chan Vibol V Alexander Neal N Bradley John J Liverani Marco M Prasetyo Didot Budi DB Rachmat Agus A Lopes Sergio S Hii Jeffrey J Rithea Leang L Shafique Muhammad M Hustedt John J

PLoS neglected tropical diseases 20180216 2

<h4>Background</h4>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 ...[more]

PMID: 29451879

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Project description:BackgroundHypertension contributes significantly to cardiovascular and renal diseases. It can be controlled by lifestyle modifications, however in poor communities there is lack of awareness, and treatment and control of hypertension is often poor. The aim of this study was to determine hypertension knowledge, attitudes and practices in a disadvantaged rural community in Matebeleland South province of Zimbabwe.MethodsWe conducted a descriptive cross-sectional survey on hypertensive patients in the community. A pre-tested and validated interviewer-administered questionnaire was used to collect demographic, awareness, treatment and control data among consenting hypertensive patients.Results304 respondents were enrolled into the study (mean age, 59 years), and a majority were women (65.4%). The treatment default rate was 30.9%, and 25% of respondents on medication did not know their blood pressure control status. Knowledge on hypertension was poor, with 64.8% of respondents stating that stress was its main cause, 85.9% stated that palpitations were a symptom of hypertension and 59.8% of respondents added salt on the table. The more education respondents had received, the more likely they were knowledgeable about hypertension (odds ratio for secondary education, 3.68 [95% CI: 1.61-8.41], and for tertiary education, 7.52 [95% CI: 2.76-20.46], compared to those without formal education). Those who believed in herbal medicines (50.7%) and those who used traditional medicines (14.5%) were 53% (95% CI: 0.29-0.76) and 68% (95% CI: 0.29-0.76) less likely to be knowledgeable about hypertension compared to those who did not believe in or use traditional medicines, respectively.ConclusionMembers of the community had poor knowledge on hypertension. This was associated with a lack of education and with strong beliefs in herbal and traditional medicines in the community, which influenced attitudes and practices on hypertension. Dietary risk factors were linked to poor knowledge. Hypertensive medicine shortages at the clinic resulted in worsened hypertension care and poor hypertension outcomes in the community.

Project description:BackgroundWhile vector-borne diseases (VBDs) pose an important public health problem worldwide, there is a limited and conflicting knowledge about such illnesses in rural or urban settings. The present study aimed to explore the social representations (SRs) held by people in the state of Puebla, Mexico on insects and the diseases they transmit. Understood as the group of ideas held and shared by a group of human beings which enable them to understand and interpret the world, SRs constitute what could be called a collective science or knowledge of everyday life.MethodsThe present study was conducted in six municipalities in the state of Puebla, wherein an open-ended questionnaire was applied with three age ranges. A total of 360 questionnaires were applied with people dedicated to a variety of activities. The survey data was analyzed to identify the SR's structure (the central nucleus of the SR and its peripheral system) and the level of organization in order to explore the degree to which the ideas that constitute it are shared and based on consensus. To describe the structure of the SR, a network analysis was conducted and complemented by a correspondence analysis, which also enables the differences between social groups to be identified.ResultsPopular knowledge on insects and VBDs is often limited, even in communities in which more than one-vector insect is found. The elements that were most frequently mentioned in the data, as pertaining to the insect-disease relationship, were mosquitoes and dengue fever, with scorpions (which are arachnids and not insects) receiving the second-highest number of mentions, while other insects such as kissing bugs, flies, and cockroaches were also mentioned as transmitting VBDs. While television was the main information source on VBDs for the residents of these communities, biology books were also mentioned. Chemical control measures (insect repellents) were the most used prevention method, and traditional medicine was the remedy most commonly used to treat insect bites and transmitted diseases. Entomophobia was the main cause for the respondents' fear and rejection of insects. Beyond the deleterious effects of many insects, those surveyed also recognized a positive relationship with insects due to economic and nutritional benefits they provide.ConclusionsThe present study provides relevant information on how insects and the diseases they transmit are perceived by rural and urban communities. Although the population is aware of dengue fever and the role of mosquitoes in transmitting it, information campaigns are required for other historically neglected VBDs, such as leishmaniasis, Chagas disease, and, even, rickettsiosis. As it is important to understand the impact that these illnesses have on communities further research is required to ensure that better information and guidance is provided on VBDs in order to develop a culture of illness prevention in not only the rural but also the metropolitan communities of the state of Puebla.

Project description:BackgroundDespite being entirely preventable, canine rabies still kills 55,000 people/year in developing countries. Information about local beliefs and practices can identify knowledge gaps that may affect prevention practices and lead to unnecessary deaths.Methodology/principal findingsWe investigated knowledge, attitudes and practices related to rabies and its prevention and control amongst a cross-section of households (n = 5,141) in urban and rural areas of central, southern and northern Tanzania. Over 17% of respondents owned domestic dogs (average of 2.3 dogs/household),>95% had heard about rabies, and>80% knew that rabies is transmitted through dog bites. People who (1) had greater education, (2) originated from areas with a history of rabies interventions, (3) had experienced exposure by a suspect rabid animal, (4) were male and (5) owned dogs were more likely to have greater knowledge about the disease. Around 80% of respondents would seek hospital treatment after a suspect bite, but only 5% were aware of the need for prompt wound cleansing after a bite. Although>65% of respondents knew of dog vaccination as a means to control rabies, only 51% vaccinated their dogs. Determinants of dog vaccination included (1) being a male-headed household, (2) presence of children, (3) low economic status, (4) residing in urban areas, (5) owning livestock, (6) originating from areas with rabies interventions and (7) having purchased a dog. The majority of dog-owning respondents were willing to contribute no more than US$0.31 towards veterinary services.Conclusions/significanceWe identified important knowledge gaps related to, and factors influencing the prevention and control of rabies in Tanzania. Increasing knowledge regarding wound washing, seeking post-exposure prophylaxis and the need to vaccinate dogs are likely to result in more effective prevention of rabies; however, greater engagement of the veterinary and medical sectors is also needed to ensure the availability of preventative services.

Project description:BACKGROUND:Despite rapid upscale of insecticide-treated nets (ITNs) and indoor residual spraying (IRS), malaria remains a major source of morbidity and mortality in Zambia. Uptake and utilization of these and novel interventions are often affected by knowledge, attitudes and practices (KAP) amongst persons living in malaria-endemic areas. The aims of this study were to assess malaria KAP of primary caregivers and explore trends in relation to ITN use, IRS acceptance and mosquito density in two endemic communities in Luangwa and Nyimba districts, Zambia. METHODS:A cohort of 75 primary caregivers were assessed using a cross-sectional, forced-choice malaria KAP survey on ITN use, IRS acceptance and initial perception of a novel spatial repellent (SR) product under investigation. Entomological sampling was performed in participant homes using CDC Miniature Light Traps to relate indoor mosquito density with participant responses. RESULTS:Ninety-nine percent of participants cited bites of infected mosquitoes as the route of malaria transmission although other routes were also reported including drinking dirty water (64%) and eating contaminated food (63%). All caregivers agreed that malaria was a life-threatening disease with the majority of caregivers having received malaria information from health centers (86%) and community health workers (51%). Cumulatively, self-reported mosquito net use was 67%. Respondents reportedly liked the SR prototype product but improvements on color, shape and size were suggested. Overall, 398 mosquitoes were captured from light-trap collections, including 49 anophelines and 349 culicines. Insecticide treated nets use was higher in households from which at least one mosquito was captured. CONCLUSIONS:The current study identified misconceptions in malaria transmission among primary caregivers indicating remaining knowledge gaps in educational campaigns. Participant responses also indicated a misalignment between a low perception of IRS efficacy and high stated acceptance of IRS, which should be further examined to better understand uptake and sustainability of other vector control strategies. While ITNs were found to be used in study households, misperceptions between presence of mosquitoes and bite protection practices did exist. This study highlights the importance of knowledge attitudes and practice surveys, with integration of entomological sampling, to better guide malaria vector control product development, strategy acceptance and compliance within endemic communities.

Project description:BackgroundThe average annual reported dengue incidence in Cambodia is 3.3/1,000 among children < 15 years of age (2002-2007). To estimate the economic burden of dengue, accurate cost-of-illness data are essential. We conducted a prospective, community-based, matched case-control study to assess the cost and impact of an episode of dengue fever and other febrile illness on households in rural Cambodia.MethodsIn 2006, active fever surveillance was conducted among a cohort of 6,694 children aged < or = 15 years in 16 villages in Kampong Cham province, Cambodia. Subsequently, a case-control study was performed by individually assigning one non-dengue febrile control from the cohort to each laboratory-confirmed dengue case. Parents of cases and controls were interviewed using a standardized questionnaire to determine household-level, illness-related expenditures for medical and non-medical costs, and estimated income loss (see Additional file 1). The household socio-economic status was determined and its possible association with health seeking behaviour and the ability to pay for the costs of a febrile illness.ResultsBetween September and November 2006, a total of 60 household heads were interviewed: 30 with dengue-positive and 30 with dengue-negative febrile children. Mean total dengue-related costs did not differ from those of other febrile illnesses (31.5 vs. 27.2 US dollars, p = 0.44). Hospitalization almost tripled the costs of dengue (from 14.3 to 40.1 US dollars) and doubled the costs of other febrile illnesses (from 17.0 to 36.2 US dollars). To finance the cost of a febrile illness, 67% of households incurred an average debt of 23.5 US dollars and higher debt was associated with hospitalization compared to outpatient treatment (23.1 US dollars vs. 4.5 US dollars, p < 0.001). These costs compared to an average one-week expenditure on food of 9.5 US dollars per household (range 2.5-21.3). In multivariate analysis, higher socio-economic status (odds ratio [OR] 4.4; 95% confidence interval [CI] 1.4-13.2), duration of fever (OR 2.1; 95%CI 1.3-3.5), and age (OR 0.8; 95%CI 0.7-0.9) were independently associated with hospitalization.ConclusionIn Cambodia, dengue and other febrile illnesses pose a financial burden to households. A possible reason for a lower rate of hospitalization among children from poor households could be the burden of higher illness-related costs and debts.

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

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

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