Socio-demographic characteristics
The profile of the respondents is given in Table 1 that summarizes the socio-demographic characteristics of study participants. There were 506 male (50.1%) and 504 female (49.9%) respondents among the 1010 responders and the majority (54.6%; 551/1010) were 16 to 30 aged. Fifty four percent of the participants were from rural community (village) whereas 26.6% and 19.4% were from semi-town and city, respectively. About 12.6% of the respondents were illiterate and nearly 18% were graduates. Of the total respondents, 34.4% were students; 21.1% were housewives and 40.7% had monthly family income less than 15,000 BDT. Closely 16% peoples were from lower class family as well as almost 47% were from middle class family among the respondents.
Table 1: Socio-demographic characteristics of dengue fever in Bangladesh.
Characteristics
|
n (%)
|
95% CI
|
Gender
|
Male
|
506 (50.1)
|
1.47 – 1.53
|
Female
|
504 (49.9)
|
Age
|
1 – 15
|
38 (3.8)
|
2.54 – 2.65
|
16 – 30
|
551 (54.6)
|
31 – 45
|
249 (24.7)
|
46 – 60
|
124 (12.3)
|
>60
|
48 (4.8)
|
Living place
|
Village
|
545 (54.0)
|
1.61 - 1.70
|
Semi Town
|
269 (26.6)
|
City
|
196 (19.4)
|
Literacy status
|
No formal schooling (illiterate)
|
127 (12.6)
|
3.21 – 3.38
|
Primary
|
172 (17.0)
|
Secondary
|
258 (25.5)
|
Intermediate
|
227 (22.5)
|
Graduate
|
180 (17.8)
|
Post Graduate
|
46 (4.6)
|
Employment status
|
Job holder
|
88 (8.7)
|
4.78 – 5.04
|
Teacher
|
75 (7.4)
|
Businessman
|
107 (10.6)
|
Farmer
|
53 (5.2)
|
Student
|
347 (34.4)
|
Laborer
|
49 (4.9)
|
Housewife
|
213 (21.1)
|
Nothing as mentions
|
38 (3.8)
|
Others
|
40 (4.0)
|
Family income (Taka/month)
|
<15,000
|
411 (40.7)
|
1.86 – 1.97
|
<30,000
|
344 (34.1)
|
<50,000
|
187 (18.5)
|
>50,000
|
68 (6.7)
|
Socio economic status
|
Lower
|
163 (16.1)
|
2.39 – 2.50
|
Lower middle
|
303 (30.0)
|
Middle
|
474 (46.9)
|
Upper middle
|
70 (6.9)
|
*CI = Confidence Interval
Knowledge, attitude and preventive practice (KAP) towards DF.
Among the total respondents, 93.8% had heard about dengue fever (DF) and most of the participants (61.3%) were aware about dengue outbreak in Bangladesh (Table 2). Most of them (91.3%) were believed that it was dispatched through mosquito bites. A few of them (2.1%) opined that this disease is transmitted through dirty drinking water.
Around two-third of the respondents could correctly response that Aedes mosquito spread dengue virus. The majority of the respondents (45.7%) had misconceptions that unclean water-holding containers could be potential breeding places for Aedes mosquito. Less than half of the people (43.1%) knew that mosquito usually bites during sunrise/sunset.
Fever was the most consistent response (36.6%) when asked about the common symptoms of dengue. About half (50.7%) of the research participants believed that dengue could be transmitted and 1/3 (289; 28.6%) supposed it could be transmitted through blood transfusion. Dengue fever can be avoided by using preventive measures. For personal-protective measures, 38.5% and 22.1% were narrated that mosquito coils and mosquito nets were considered the most usual and effective options for prevention while some (8.8%) were used mosquito repellant/cream as an alternative (Table 2).
Table 2: Knowledge, attitude and preventive practice (KAP) towards dengue fever in different regions of Bangladesh.
Variables
|
n (%)
|
95% CI
|
Heard about dengue fever
|
Yes
|
947 (93.8)
|
1.05 – 1.08
|
No
|
63 (6.2)
|
Mode of spread
|
Mosquito's bite
|
922 (91.3)
|
1.21 – 1.33
|
Dirty drinking water
|
21 (2.1)
|
Contaminated food
|
0 (0.0)
|
Others
|
15 (1.5)
|
Don’t know
|
52 (5.1)
|
Carrier of dengue fever
|
Aedes
|
609 (60.3)
|
2.0 – 2.17
|
Anopheles
|
27 (2.7)
|
All types of mosquito
|
55 (5.4)
|
Don’t know
|
319 (31.6)
|
Most frequent mosquito biting time
|
Sunrise/sunset
|
435 (43.1)
|
1.93 –2.06
|
Night
|
301 (29.8)
|
Afternoon
|
120 (11.9)
|
Don’t know
|
154 (15.2)
|
Dengue is transmissible
|
Yes
|
512 (50.7)
|
1.46 – 1.52
|
No
|
498 (49.3)
|
Dengue is transmitted through
|
Human to human contact
|
62 (6.1)
|
3.72 – 3.91
|
Blood transfusion
|
289 (28.6)
|
Needle stick injury
|
25 (2.5)
|
Sharing of food/ clothes with the patient
|
35 (3.5)
|
Don’t know
|
599 (59.3)
|
Common breeding site
|
In clean water
|
434 (43.0)
|
1.64 – 1.72
|
In unclean water
|
462 (45.7)
|
Don’t know
|
114 (11.3)
|
Common symptoms
|
High fever
|
370 (36.6)
|
3.95 – 4.31
|
Severe body aches
|
74 (7.3)
|
Nausea and vomiting
|
81 (8.0)
|
Red spots on the body
|
56 (5.5)
|
Diarrhea
|
12 (1.2)
|
Pain abdomen
|
8 (0.8)
|
All of the above
|
195 (19.3)
|
Don’t know
|
214 (21.2)
|
Awareness about dengue fever
|
|
Yes
|
619 (61.3)
|
1.36 – 1.42
|
No
|
391 (38.7)
|
Preventive measures
|
Use mosquito spray
|
92 (9.1)
|
3.76 – 4.05
|
Use mosquito coil
|
389 (38.5)
|
Use mosquito repellant/cream
|
89 (8.8)
|
Keep closed windows & doors
|
54 (5.3)
|
Use smoke to drive away mosquitoes
|
10 (1.0)
|
Keep neat & clean surroundings
|
131 (13.0)
|
Use mosquito net
|
223 (22.1)
|
Cover body with long clothes
|
4 (0.4)
|
Do nothing
|
18 (1.8)
|
In Bangladesh, treatment seeking behavior, which is impacted by financial status subsequently, numerous individuals purchased medication from nearby pharmacy when they got affected of any diseases without any prescription. About 48% (485/1010) respondents were answered to take medicine without prescription followed by 29.3% (296/1010) took medicine with prescription after noticing any symptoms of fever (Figure 2).
When respondents were asked about the treatment, majority (89.6%) of them were answered dengue fever was treatable but most of them (59.3%) not to be aware of the primary treatment. Only 21.8% of people believed that different test was performed immediately after suffering from dengue fever though 38.3% of people didn't face dengue fever yet (Table 3).
Table 3: Knowledge about dengue fever treatment in Bangladesh.
Variables
|
n (%)
|
95% CI
|
Dengue fever is treatable
|
Yes
|
905 (89.6)
|
1.12 – 1.18
|
No
|
59 (5.8)
|
Don’t know
|
46 (4.6)
|
Knowing primary treatment of Dengue fever
|
Yes
|
411 (40.7)
|
1.56 – 1.62
|
No
|
599 (59.3)
|
Knowledge about which tests are required to diagnose
|
Yes
|
308 (30.5)
|
1.67 – 1.72
|
No
|
702 (69.5)
|
Test after suffering from fever
|
Immediately
|
220(21.8)
|
3.39 – 3.58
|
After getting serious condition
|
67(6.6)
|
After a few days
|
110 (10.9)
|
Never do test
|
226 (22.4)
|
Didn't face yet
|
387 (38.3)
|
Source of information on dengue fever
In this study, 44.2% respondents identified television/radio was the leading source of information about dengue fever followed by friends and family (26.8%). On the other hand, 13.2% stated that newspapers/social media cover information on dengue and about 6.3% of respondents had obtained knowledge through different educational institutions (Figure 3).
Association among knowledge, awareness, and practice about dengue
Literacy have a significant association with the basic knowledge about dengue. The educated participants significantly (p<0.001) had clear concept about Aedes mosquito and their breeding sites than the illiterate participants (Figure 4: A and B).
Around all of the participants who had formal education had sufficient knowledge about dengue virus and its transmission. There was an apparent trend noticed among the different occupations whereby the better paid the occupation the better knowledge. Significant associations (p<0.001) were found between knowledge scores of dengue and living place, education level, and occupation (Table 4).
The respondents who lived in the city were more aware than those who were lived in villages/rural area and semi town in Bangladesh. Participants with a qualification of graduate were 1.5 times more aware as compared to illiterate. There were found significant association (p<0.05) among all of the socio-demographic variables with awareness on dengue except age and gender (Table 5). Table 6 represents the significant positive association of knowledge with preventing ways and preventing practice of Aedes reproduction (p<0.05).
Table 4: Association between knowledge and socio-demographic variables on dengue fever (n = 1010).
Description
|
Knowledge on dengue
|
Insufficient
Knowledge n (%)
|
Sufficient
Knowledge n (%)
|
Chi-square
|
P-value
|
OR
|
95% CI
|
Age (years)
1-15
16-30
31-45
46-60
>60
|
3(7.9)
26(4.7)
19(7.6)
10(8.1)
5(10.4)
|
35 (92.1)
525 (95.3)
230 (92.4)
114 (91.9)
43 (89.6)
|
5.319
|
0.256
|
-
|
-
|
Gender
Male
Female
|
46(9.1)
17(3.4)
|
460 (90.9)
487 (96.6)
|
14.115
|
<0.001
|
0.349
|
0.197-0.618
|
Living place
Village
Semi town
City
|
56(10.3)
5(1.9)
2(1)
|
489 (89.7)
264 (98.1)
194 (99)
|
33.133
|
<0.001
|
-
|
-
|
Literacy status
No formal schooling
Primary
Secondary
Intermediate
Graduate
Post-graduate
|
29(22.8)
16(9.3)
8(3.1)
3(1.3)
5(2.8)
2(4.3)
|
98 (77.2)
156 (90.7)
250 (96.9)
224 (98.7)
175 (97.2)
44 (95.7)
|
80.264
|
<0.001
|
-
|
-
|
Employment status
Job holder
Teacher
Businessman
Farmer
Student
Laborer
Housewife
Nothing as mention
Others
|
2(2.3)
2(2.7)
5(4.7)
6(11.3)
13(3.7)
14(28.6)
11(5.2)
7(18.4)
3(7.5)
|
86 (97.7)
73 (97.3)
102 (95.3)
47 (88.7)
334 (96.3)
35 (71.4)
202 (94.8)
31 (81.6)
37 (92.5)
|
62.435
|
<0.001
|
-
|
-
|
Socio-economic status
Lower
Lower middle
Middle
Upper middle
|
9(5.5)
21(6.9)
30(6.3)
3(4.3)
|
154 (94.5)
282 (93.1)
444 (93.7)
67 (95.7)
|
0.855
|
0.836
|
-
|
-
|
*OR= Odd Ratios
Table 5: Association between awareness and socio-demographic variables on dengue.
Description
|
Awareness on dengue
|
Aware n(%)
|
Unaware n(%)
|
Chi-square
|
P-value
|
OR
|
95% CI
|
Age (years)
1-15
16-30
31-45
46-60
>60
|
21(55.3)
351(63.7)
151(60.6)
66(53.2)
30(61.3)
|
17(44.7)
200(36.3)
98(39.4)
58(46.8)
18(37.5)
|
5.4
|
0.248
|
-
|
-
|
Gender
Male
Female
|
305(60.3)
314(62.3)
|
201(39.7)
190(37.7)
|
0.436
|
0.509
|
0.918
|
0.713-1.183
|
Living place
Village
Semi town
City
|
331(60.7)
153(56.9)
135(68.9)
|
214(39.3)
116(43.1)
61(31.1)
|
7.035
|
0.030
|
-
|
-
|
Literacy status
No formal schooling
Primary
Secondary
Intermediate
Graduate
Post-graduate
|
65(51.2)
87(50.6)
142(55)
158(69.6)
135(75)
32(69.6)
|
62(48.8)
85(49.4)
116(45)
69(30.4)
45(25)
14(30.4)
|
40.233
|
<0.001
|
-
|
-
|
Employment status
Job holder
Teacher
Businessman
Farmer
Student
Laborer
Housewife
Nothing as mention
Others
|
59(67)
52(69.3)
70(65.4)
24(45.3)
231(66.6)
20(40.8)
121(56.8)
23(60.5)
19(47.5)
|
29(33)
23(30.7)
37(34.6)
29(54.7)
116(33.4)
29(59.2)
92(43.2)
15(39.5)
21(52.5)
|
27.521
|
0.001
|
-
|
-
|
Socio-economic status
Lower
Lower middle
Middle
Upper middle
|
91(55.8)
171(56.4)
306(64.6)
51(72.9)
|
72(44.2)
132(43.6)
168(35.4)
19(27.1)
|
11.139
|
0.011
|
-
|
-
|
Table 6: Association among aware and preventing ways with knowledge of dengue fever.
Independent variable
|
P value
|
OR
|
95% CI
|
Aware
|
0.667
|
1.120
|
0.667 - 1.882
|
Preventing ways
|
0.002
|
2.248
|
1.335 – 3.786
|
Preventing practice ofAedes reproduction
|
< .001
|
1.113
|
1.084 – 1.143
|