|Year : 2022 | Volume
| Issue : 3 | Page : 176-181
Relationship between Aedes aegypti indices with perception and practices of dengue in an urban community of Mysore
BC Sunil, Praveen Kulkarni, N Renuka, M R Narayana Murthy
Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
|Date of Submission||24-Mar-2022|
|Date of Decision||15-Apr-2022|
|Date of Acceptance||24-Apr-2022|
|Date of Web Publication||13-Jul-2022|
Dr. Praveen Kulkarni
Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka
Source of Support: None, Conflict of Interest: None
Background: Dengue is one of the major public health problems in the world. Currently, dengue is endemic in more than 100 countries of Asian pacific region. Prevention and control of dengue is largely influenced by the level of awareness and the preventive practices people undertake. In this background, the present study was conducted to find out the relationship between Aedes aegypti indices and perception and practices regarding dengue and its prevention. Materials and Methods: This cross-sectional study was conducted in an urban slum for the period of 1 year among 270 households selected by probability proportionate to size technique. Data were collected by structured questionnaire with details on sociodemographic characteristics, perception, and practices adopted by people toward dengue and its prevention. Larva survey was conducted by observing for the A. aegypti larvae in the containers within and outside the households. Results: Among 270 households included in the present study, overall, 70 (25.9%) and 96 (35.6%) of the study respondents were having poor and average levels of perception. 22 (8.1%) and 163 (60.4%) of respondents had poor and average levels of dengue prevention practices, respectively. Household index, container index, and Bretau's index (BI) were 5.52%, 6.05%, and 8.51%, respectively. Median perception and practice scores among the respondents of households with larva breeding were significantly lower as compared to the ones without larva breeding. Conclusion: Majority of the study participants had poor to average levels of perception and practices regarding dengue and its prevention. These scores were significantly lower among households with active larva breeding.
Keywords: Aedes aegypti indices, dengue, larva breeding, perception, practices
|How to cite this article:|
Sunil B C, Kulkarni P, Renuka N, Murthy M R. Relationship between Aedes aegypti indices with perception and practices of dengue in an urban community of Mysore. Indian J Med Spec 2022;13:176-81
|How to cite this URL:|
Sunil B C, Kulkarni P, Renuka N, Murthy M R. Relationship between Aedes aegypti indices with perception and practices of dengue in an urban community of Mysore. Indian J Med Spec [serial online] 2022 [cited 2022 Nov 26];13:176-81. Available from: http://www.ijms.in/text.asp?2022/13/3/176/350777
| Introduction|| |
Dengue fever is one of the major public health problems in the world. In fact, these diseases become hyper-endemic in rural, peri-urban, and urban areas with sporadic and frequent epidemics. Currently, dengue infection is endemic in more than 100 countries of Asian-pacific region.,
In India, epidemics of dengue have become more frequent in urban zones and have rapidly found their ways to rural localities. Aedes aegypti is one of the most competent vectors responsible for the transmission of dengue, yellow fever, and chikungunya viruses. Due to its domestic ecological feature, A. aegypti breeds in the small and artificial collection of water, placed inside or near human dwellings.
Knowledge related to dengue, its prevention and control is the driving force for community participation in dengue prevention. The perception of the community toward dengue, its modes of transmission, vector breeding strategies, vector control measures, personal protection, clinical features, treatment options, early warning signals, and the willingness to take preventive measures in their home environment are the important determinants of their participation in dengue prevention and control programs. Thus, it is important to know the public's perception, attitude, and their response toward dengue and its prevention.
Larva indices, which indicate the active breeding spots of A. aegypti in and around the households, are the major predictors of disease transmission and outbreak. Perception of people on dengue prevention also determines the magnitude of these larva indices. People who are aware of larva breeding places and their potential role in the transmission of dengue would tend to undertake source reduction and chemical measures which are reflected on the larva indices in and around their households. People who are less aware of vector-borne transmission of disease and larva control measures tend to neglect these larva breeding places which is reflected on high larva indices in around their houses.
There are several studies available from the different parts of the world and countries on perception and practices regarding dengue and its prevention at both community and facility settings. There are few studies also available on the larva indices of A. aegypti at the community level. However, there are very few studies on the relationship between perception on dengue prevention and larva indices at the southern part of India. This relationship gives us an idea about how knowledge regarding dengue and its prevention is reflected on larva indices at the community setting. In this background, the present study was conducted to find out the relationship between A. aegypti indices with perception and practices of dengue in an urban community of Mysore.
| Materials and Methods|| |
This community-based cross-sectional study was conducted in the urban field practice area of Department of Community Medicine, JSS Medical College, Mysore, for a period of 1 year (January to December 2019) after obtaining Institutional Ethics Committee clearance. Based on the reported prevalence of knowledge regarding dengue to be mosquito-borne disease to be 80% according to a study conducted by Boornema et al., with 5% relative allowable error, Alpha level of 5%, the sample size was calculated to be 256 with 5% nonresponse rate; the final sample size was worked out to 269 which was rounded off to 270.
The urban field practice area is conventionally divided into six blocks for health care administrative purposes. The probability proportionate to size sampling technique was applied based on the population in each of the blocks to calculate the number of houses to be included in each of these blocks. After visiting each of the blocks, street and one household in the street was chosen randomly and all the consecutive houses in the street were included till the sample size for the block was achieved. The houses which were locked for three subsequent visits during the survey period were excluded from the study. From the selected households, the information was collected from an adult responsible respondent using a pretested semistructured questionnaire by the interview technique after obtaining written informed consent.
The questionnaire had following components
- Part A - Sociodemographic characteristics such as age, gender, education, occupation, socioeconomic status, marital status, and number of individuals in the family
- Part B - Perception and practices related to dengue such as vector responsible, dynamics of vector, breeding sites, source reduction, personal prophylaxis measures, health-seeking behavior, any previous history of dengue in the family in the last 1 year
- Part C - A. aegypti indices were assessed by examining the breeding sites of mosquito, the following indices were calculated,
Household index (HI)
Container index (CI)
Bretau's index (BI)
Data obtained were entered in MS Excel spreadsheet and analyzed using the SPSS software version 23 (IBM SPSS, Chicago, 2015) (Licenced to JSSAHE&R). Descriptive statistical measures were expressed as percentages, mean, and standard deviation. Data were represented in tables and graphs.
| Results|| |
Sociodemographic characteristics of respondents
Among the respondents of 270 households included in the study, majority 110 (40.7%) were in the age group of 31–45 years, 210 (77.8%) were female and 60 (22.2%) were male. Majority 98 (36.3%) of the study participants had studied up to secondary school level and 166 (61.5%) of respondents were homemakers. Sixty-eight (25.2%) participants were laborers by occupation. Majority (194; 71.9%) of the households were below poverty line and 76 (28.1%) were above poverty line. 251 (93%) were Hindus by religion followed by 12 (4.4%) Christian and 7 (2.6%) Muslims [Table 1].
Perception regarding dengue and its prevention
Among the respondents of 270 households included in the study, 215 (79.6%) had heard about dengue. Among respondents who had heard of dengue, television was the most common source of information. One hundred and sixty-seven (77.7%) participants were aware of fatal nature of dengue and 121 (56.27%) felt that dengue is more common in summers and 59 (27.44%) in the rainy season.
Among the study participants who had heard of dengue, 204 (94.88%) were aware that dengue is transmitted by mosquito bites and 97 (45.11%) knew this mosquito bites during daytime. Majority 138 (64.18%) of the participants opined this mosquito breed in sewage water and 115 (53.48%) knew breeding in the fresh artificial collection of water. 105 (48.83%), 66 (30.69%), and 41 (19.06%) mentioned that the Aedes mosquitoes often breed in water collected in empty coconut shell, thrown plastic containers, and discarded tubes/tyres, respectively. One hundred and sixty (74.4%) participants perceived preventing stagnation of water in coconut shells, tyres, and other objects as a control measure for the prevention of growth of mosquitoes. Overall, 70 (25.9%) and 96 (35.6%) of the study respondents were having poor and average levels of perception. Ninety-four (34.8%) of respondents had satisfactory and 10 (3.7%) had good levels of perception regarding dengue [Table 2].
Dengue prevention practices
Among 270 participants included in the study, 146 (54.1%) of participants used to clean the tank and other water containers weekly. Two hundred and ten (77.8%) of participants practiced personal protective measures to prevent dengue, followed by 146 (54.1%) practiced cleaning of water containers regularly, 114 (42.2%), kept their area clean, 45 (16.7%) attempted taking out water from coconut shells, tyres, and plastic bins and 35 (13.0%) regularly replaced water in flower pots. Majority 204 (75.6%) of study participants were using mosquito coils as the personal protective measure. However, 162 (60.0%), 100 (37.03%), and 53 (19.6%) used mosquito net, others (mosquito bat and neem smoke), and mosquito repellent creams, respectively. Majority of the participants 107 (49.76%) visit government hospital for the treatment in case of any symptoms suggestive of dengue and 19 (8.8%) of participants visited traditional healers. Overall 22 (8.1%) and 163 (60.4%) of respondents had poor and average levels of dengue prevention practices, respectively. Eighty-two (30.4%) of respondents had satisfactory and 3 (1.1%) had good levels of dengue prevention practices [Table 3].
Aedes aegyti indices
Among 270 households included in the study, 19 (7.0%) had adult mosquitoes inside their houses. Breeding of larvae is found in 21 (7.8%) of the households. Among these households, larvae breeding was found in 5 (23.8%) and outside in 16 (76.2%). In 19 (90.5%) of households, there was only one container which showed larva breeding and 02 (9.5%) showed breeding in more than one container. HI for the A. aegypti larva was 5.52%, CI for the A. aegypti larva was 6.05% and BI for A. aegypti larva was 8.51% [Table 4].
Relationship between perception and practices with larva breeding
Median perception and practice scores on dengue among the respondents of households with larva breeding were lower compared with the houses without larva breeding. This difference in perception score was statistically significant [Table 5].
|Table 5: Comparison of median perception and practice scores among households with and without larva breeding|
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| Discussion|| |
Dengue virus infection is increasingly recognized as one of the world's emerging infectious diseases. The prevention of dengue is possible only if people have adequate knowledge about the disease and they readily follow the prevention methods. The questionnaire-based data collection supplemented with larva surveys will give us additional information on whether the perception and practices spelled out by people match with the actual larva indices at the community level.
In the present study, 79.6% of respondents had heard of disease dengue. This finding is in similar lines with the observations made by Itrat et al. where 89.9% individuals had heard of disease. Our observations are lesser than the results of Bota et al. where 94.6% of study participants had heard of disease. The observation of the present study is higher compared to the results of a study by Shabadi et al. in the rural areas of Mysore, where only 21% of respondents mentioned that they had heard of disease. This variation in the observation may be due to the fact that, people in urban areas and having better access to health workers, health services and media have higher chances of knowing about the disease compared to people residing in the urban areas.
In the present study, 94.88% of the study participants were aware that dengue is transmitted by mosquitoes. This was similar to the results of Harish et al., where 91.2% of the study participants were aware of this transmission by the mosquito and this was much more compared to the results of Malhotra et al., where 72.62% of the study subjects were aware of this transmission by the mosquito. Wider availability of health awareness materials and media messages on the relationship between dengue and mosquito could be the probable reason for the higher levels of awareness about the mosquito borne nature of dengue.
In the present study, 73.3% of the study participants were aware dengue is a preventable disease. This was similar to the results of Malhotra et al., where only 21.1% of study participants strongly agreed and 58.75% agreed that dengue is preventable disease. Another study conducted by Harish et al., where 78.9% of study participants were aware of dengue is a preventable disease.
In the present study, 105 (48.83%), 66 (30.69%), and 41 (19.06%) mentioned that the Aedes mosquitoes often breed in the collection of water in an empty coconut shell, thrown plastic blacks, and tyres, respectively. This is similar to the results of Itrat et al., where 51.1% of study participants were aware that dengue mosquito breeds and grows in clean standing water
In the present study, 160 (74.4%) perceived preventing stagnation of water in coconut shells, tyres, and other objects as a control measure for the prevention of growth of mosquitoes. Other measures mentioned were, closing the water containers with lids 159 (74.0%), spraying chemicals over stagnant water 31 (14.4%), and fogging with insecticides 44 (20.5%). These results are marginally similar to the observations of Harish et al., where 50.2% of study participants were aware of discarding items that hold water and 5.7% of subjects were aware of covering of water storage containers. The results of the present study were better than the observations made by Shaheen et al., where 0.47% of study participants were aware of discarding items that hold water and 5.24% of participants were aware of covering of water storage containers and 0.95% of participants were aware of insecticide spray.
In the present study, 146 (54.1%) of participants responded that they clean the tank and other water containers weekly. However, 55 (20.4%), 32 (11.9%), and 29 (10.7%) mentioned that they wash tanks and other containers monthly, once in 3 month and others (daily, 2 days once), respectively. These findings were lesser compared to the observations made by Shabadi et al. in the rural areas of Mysore, where, 97% of the participants mentioned that they clean the water containers once a week. In another study conducted by Kulkarni et al., it was observed that 46.6% of subjects replied that they replace the water at least a week. The possible reason for this practice in the present study could be the irregular supply of municipal water in the urban slum. Because of this people store water for a long time and hesitate to discard the collected water and clean the containers.
In the present study, 210 (77.8%) of participants practiced personal protective measures to prevent dengue, followed by 146 (54.1%) practiced cleaning water containers regularly, 114 (42.2%), kept their area clean, 45 (16.7%) attempted taking out water from coconut shells, tyres, and plastic bins, and 35 (13.0%) regularly replaced water in flower pots. These results are similar to the observations made by Shabadi et al. where 83.3% of the participants mentioned that they remove sources of stagnant water and cover the water containers with lids.
In the present study among 270 participants, the majority 204 (75.6%) of study participants were using mosquito coils as a personal protective measure. However, 162 (60.0%), 100 (37.03%), and 53 (19.6%) mentioned that the mosquito net, others (mosquito bat and neem smoke), and mosquito repellent creams, respectively.(3.0%), of study participants were not using any personal protective measures. The results of this study are comparable to other studies done by Shaheen et al. where majority 102 (48.57%) of study participants mentioned that mosquito repellent vaporizers as common personal protective measures, followed by 70 (33.33%) as bed nets and 57 (27.14%) were relying upon mats/coils.
HI for the A. aegypti larva was 5.52%. CI and BI were 6.05% and 8.51%, respectively. In a vector survey conducted at suburban areas of Assam by Dev et al. observed that, HI, CI, and BI ranged from 3.4 to 21.5, 2.910 to 33.8, and 5.0 to 61.0, respectively. In another study conducted by Reegan et al. at Bangalore observed that HI, CI, and BI in some urban localities were 8.53, 2.32, and 7.69, respectively. Few localities in the same city found to have a much larger level of these indices to the extent of HI to be 52.94 CI to be 24.08 and BI of 62.74. The probable reasons for these variations are the seasonal breeding of the larva and the source reduction strategies adopted by the community and government.
In the present study, median perception and practice scores related to dengue and its prevention among the respondents of households with larva breeding were significantly lower compared with the houses without larva breeding. Qualitatively, the households with poor to average levels of perception and practice regarding dengue and its prevention were found to have active larva breeding compared to the households with satisfactory and good levels of perception and practice.
| Conclusion|| |
Majority of study participants had poor to average levels of perception and practices regarding dengue and its prevention. These scores were significantly lower among households with active larva breeding. Thus, there is a need to intensify health education through behavior change communication strategies at community levels on the various domains of dengue and its prevention. Regular larva surveys should be conducted to identify active larva breeding places involving community-level health workers on regular basis. Households with active larvae breeding should be mapped and they should be given special focus on health education and behavior change interventions.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]