Journal of Public Health and Development

Vol.22 No.2 May-August 2024

ORIGINAL ARTICLE
Survey of knowledge and practices of dengue fever prevention
related to sociodemographic status: community-based study in
Bandung, Indonesia
Agung Sutriyawan1, Hairil Akbar2, Edwina Rudyarti3, Ramdhani M Natsir4, Masruroh
Masruroh5, Devin Mahendika6, Mira Miraturrofi’ah7
1
Department of Public Health, Bhakti Kencana University, Bandung, Indonesia
2
Department of Public Health, Graha Medika Institute of Health and Technology, Kotamobagu, Indonesia
3
Department of Occupational Health and Safety, Medika Suherman University, Cikarang, Indonesia
4
Department of Medical Laboratory Technology, Poltekes Kemenkes Maluku, Ambon, Indonesia
5
Department of Geography Education,, Universitas Negeri Gorontalo, Gorontalo, Indonesia
6
Ranai Health Center, Natuna, Indonesia
7
Department of Midwifery, Rajawali Health Institute, Bandung, Indonesia

Corresponding Author: Agung Sutriyawan Email: [email protected]

Received: 30 January 2024 Revised: 24 February 2024 Accepted: 25 February 2024 Available online: May 2024
DOI: 10.55131/jphd/2024/220203

ABSTRACT

Dengue fever has become an endemic in Bandung city and this disease poses a serious
public health threat in Indonesia. This study aimed to examine sociodemographic factors,
experiences with dengue fever and their relationship with knowledge and practice related to
dengue fever prevention. This research was considered as a cross-sectional and community-
based study. Systematic random sampling was performed, and samples were taken at three
intervals, where one participant in every third house that researchers passed by was chosen for
the interview. The sample was 559 participants. Participants involved in this study met the
inclusion criteria, namely individuals aged 18 years and above, local residents, and able to
understand the questions. Data were collected using a questionnaire. Data analysis was carried
out using logistic regression. Multivariate test results showed high knowledge scores among
participants aged over 40 years (OR=30.908, 95% CI 16.490-57.930, P=0.000), participants
with an educational degree (OR=4.028, 95% CI 2.226-7.288, P =0.000), participants who
worked as private employees and were self-employed were less likely (OR=0.235, 95% CI
0.098-0.560, P=0.001 and OR= 0.262, 95% CI 0.107-0.638, P=0.003) to have better knowledge
of dengue fever compared to those who worked as government employees, had an income of
more than IDR 4,000,000 (OR=2.275, 95% CI 1.318-3.928, P=0.003), and had experienced
dengue fever (OR=3.140, 95% CI 1.484-6.640, P=0.003). Meanwhile, dengue fever prevention
practice scores were higher in participants aged 25-39 years (OR=18.163, 95% CI 16, 8.056-
40.947, P=0.000), those who had an educational degree (OR=6.217, 95% CI 3.793-10.191, P
=0.000), and participants who worked as housewives were less likely (OR=0.286, 95% CI
0.129-0.634, P=0.002) to practice dengue fever prevention compared to participants who had
other jobs. Participants who had experienced dengue fever were less likely (OR=0.271, 95%
CI 0.144-0.510, P=0.023) to practice dengue fever prevention compared to participants who
never had dengue fever, and had a high knowledge score (OR=4.037, 95% CI 2.201-7.406,
P=0.000). Dengue fever prevention practices are closely related to knowledge scores; therefore,
dengue fever prevention should be emphasised through effective education programmes, and
public health promotion initiatives by health officials should be conducted especially in densely
populated areas.

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Vol.22 No.2 May-August 2024

Key words:
dengue fever; prevention practices; knowledge; sociodemographic

Citation:
Agung Sutriyawan, Hairil Akbar, Edwina Rudyarti, Ramdhani M Natsir, Masruroh Masruroh, Devin
Mahendika, Mira Miraturrofi’ah. Survey of knowledge and practices of dengue fever prevention related to
sociodemographic status: community-based study in Bandung, Indonesia. J Public Hlth Dev. 2024;22(2):26-38
(https://doi.org/10.55131/jphd/2024/220203)

INTRODUCTION Bandung City in the last three years has

increased. In 2020 there were 2,790 cases,
Dengue fever is one of the most which increased in 2021 to 3,743 cases, and
common public health problems in tropical increased again in 2022 to 5,205 cases.5
and subtropical countries. Over the past Globally, dengue fever transmission
decades, the prevalence of dengue fever has has been linked to a variety of social
increased substantially, with approximately factors, including education level,
50% of the global population (0.25 billion household characteristics, uncontrolled
people) at risk of dengue infection.1 population growth, water supply (i.e., poor
Transmitted by Aedes aegypti (L.) and sanitation and water-storing practices),
Aedes albopictus (Skuse), dengue can electricity availability, vegetation cover,
occasionally progress to a severe stage human behavior, climatic variations, and
known as dengue fever, which can cause the abundance of Aedes mosquitoes.6,7 To
severe complications and potentially lead to achieve effective disease control, society
death in humans.2 Currently, there is no should be empowered with proper
specific treatment available to cure this knowledge related to dengue fever
disease. preventive strategies because human
Each year, approximately 50 behavior plays a key role in facilitating
million dengue virus infections occur and dengue vectors (providing a favorable
approximately half a million people environment for breeding and blood meals)
contract severe dengue, causing significant and disease transmission.8 Society with
morbidity and mortality worldwide.3 higher socioeconomic status and a better
In 2022, dengue fever continued to understanding of dengue fever (in terms of
affect several countries, with cases reported knowledge, attitudes, and prevention
increasing in several countries including practices) has resulted in more successful
Indonesia. There were 129,650 cases of disease control. For instance, in the
dengue fever recorded in Indonesia in 2015. Malaysian state of Selangor, human
This is an increase compared to the number behavior has a significant impact on the
of cases in 2014, which was around 99,499 spread and transmission of dengue fever.9
cases. In addition, in 2022, there were Prior studies have reported that
143,266 cases with 1,237 deaths. The individuals lacking knowledge about
number of cases and deaths due to dengue dengue fever demonstrated fewer
fever has increased compared to 2021, preventive practices compared to those who
which was 73,518 cases and 705 deaths. had more knowledge about the disease.10 A
Among the 10 provinces that have reported recent study found that there is a weak
this outbreak, the incidence rate (IR) in association between knowledge about
West Java is the highest in Indonesia at dengue fever and prevention practices
72.29.4 The number of dengue cases in among the Indonesian population.11
Nevertheless, evidence suggests that higher
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Vol.22 No.2 May-August 2024

knowledge did not necessarily result in the prevention in society. Ethical clearance and
adoption of the recommended preventive permission for this research were obtained
behaviours.12,13 Therefore, further from the health research ethics committee
investigation is important to find out the of Bhakti Kencana University with
association between knowledge and dengue Number. 083/09.KEPK/UBK/VII/2023.
prevention practices. All research participants had given their
In addition, many other studies have permission to be part of the study and
investigated the level of knowledge of the voluntarily provided information needed
general public about dengue fever and how for this study. Informed consent was
to prevent it. The intended studies had been written and signed by all participants before
conducted in Vietnam,14 Indonesia,15 starting the interview.
Brazil,16 Republic of Yemen,17 Mexico,
Colombia,18 Australia,19 and Malaysia.20 Population and study sample
Currently, the prior studies in Indonesia The study population included all
only focused on risk factors associated with people residing in Bandung city, Indonesia.
dengue fever,21 and prevention efforts The sample size was calculated using A-
through removing places where mosquitoes priori Sample Size for Structural Equation
lay eggs.22,23 The increasing trends of Models Formulas (power test = 80% and
dengue fever are particularly affecting probability level = 5%) and resulted in a
densely populated and endemic areas. The sample size of 559 participants. Further, the
Indonesian government has supported sampling technique was performed by
prevention and control efforts through applying systematic random sampling,
mosquito nest eradication programs. To where one participant in every third house
support the program, identifying and that researchers passed by was chosen to do
understanding the role of the interview. During visits to each house,
sociodemographics in the increase of only the head of the household (father) was
dengue fever cases can provide insights into interviewed. If the head of the household
prevention efforts by targeting individuals was unavailable, other eligible family
prone to dengue fever and improving members were randomly selected as long as
dengue fever prevention practices, as well they could meet the following inclusion
as facilitating authorities in dengue fever criteria such as being 18 years old, local
management. This study aims to identify residents, and able to understand the
potential predictors and analyze questions asked by the interviewer. Data
sociodemographic factors, participants' collection was conducted by researchers
experiences with dengue fever and their and assisted by 5 enumerators. Enumerators
association with dengue prevention were trained before going to the field to
knowledge and practices among the collect research data.
communities of Bandung City, Indonesia.
Data collection
METHOD The questionnaire used in this study
is a questionnaire used by previous
Study Design and Location researchers and translated into Indonesian
Cross-sectional quantitative language. The questionnaire was adapted
research was conducted in Bandung City, from “Practices of Dengue Fever
West Java Province, Indonesia. This design Prevention and the Associated Factors
was used to analyze the relationship among the Orang Asli in Peninsular
between sociodemographic factors and Malaysia” research by Chandren et al.
knowledge and practice of dengue fever (2015). The Cronbach's alpha coefficient
measurement for dengue fever knowledge

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was 0.916, indicating high internal “always”. Some negatively worded items
consistency. Meanwhile, the Cronbach's were reversed and recoded during the data
alpha coefficient measurement for self- analysis process. Possible scores ranged
reported preventive practices in this study from 0 to 72. The cutoff point for
was 0.655, indicating good internal preventive practices was categorized as a
consistency.10 low score if the participant's answer score
Knowledge related to the dengue was 0-43 (percentage of answer score <
fever section consisted of 6 parts, namely: 60%), and a high score if the participant's
1) dengue fever and Aedes aegypti and answer score was 44-72 (percentage of
Aedes albopictus characteristics; 2) answer score ³60%) 20.
transmission; 3) signs and symptoms of
dengue hemorrhagic fever; 4) signs and Statistical Analysis
symptoms of dengue fever; 5) prevention Data obtained in the study was
practices for dengue fever; and 6) analyzed using IBM SPSS Statistics 26. In
treatment, curability and precautionary addition to descriptive analysis, the data
measures for dengue fever. The knowledge were tested for a significant relationship
questionnaire consisted of 41 items using between the associative variables and the
the Guttman Scale. For each statement, outcome variables using the chi-square test,
participants could choose between 3 with P < 0.05. Knowledge scores were
response categories: “yes,” “no,” and “don't associated with sociodemographic status
know.” For data analysis, participants’ and experience with dengue fever.
responses were given a score of 1 for a Meanwhile, the dengue fever prevention
correct response and 0 for an incorrect or practice score was associated with
“don't know” response. Some negatively sociodemographic status, experience of
worded items were reversed and recoded dengue fever, and knowledge scores using
during the data analysis process. Thereby, crosstab and chi-square analysis to see how
possible scores ranged from 0 to 41. Higher these variables were associated with each
scores indicated greater knowledge about other. Multivariate logistic regression
dengue fever. The cutoff point for model was used to examine the effect of
knowledge was categorized as a low level sociodemographic status and experience
of knowledge if the participants’ response with dengue fever on knowledge of dengue
score was 0-28 (percentage of correct fever. In addition, a multivariate logistic
answer score < 70%), while the level of regression model was used to examine the
knowledge was high if the participants’ effect of sociodemographic status,
response score was 29-41 (percentage of experience of dengue fever, and knowledge
correct answer score ³ 70%) 20. of dengue fever prevention practices. In the
Meanwhile, the dengue fever modeling strategy, variables were included
prevention practices section employed if they had p<0.05 on bivariate analysis.
previous research questionnaires. It Associations were expressed as adjusted
consisted of 2 parts: 1) preventive measures odds ratios with 95% confidence intervals
reducing mosquito breeding habitats; and for each variable included in the
2) preventive measures reducing mosquito multivariate model.
bites, which were assessed, respectively
using items 10 and 8. The questionnaire RESULTS
used a Likert scale with answer options 0
for “never”, 1 for “rarely”, 2 for
A total of 559 participants were
sometimes”, 3 for “often”, and 4 for
involved in this study. Among them, 312
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Vol.22 No.2 May-August 2024

(55.8%) were male and 247 (44.2%) were Aedes albopictus mosquitoes and 94.5% (n
female participants. Most participants (n = = 528) of them knew that draining/cleaning
273, 48.8%) were aged between 25-39 water reservoirs around the house is an
years old. Approximately, 40.8% of effective preventive method for dengue
participants were Sundanese, with an fever. Only a minority of the participants (n
educational degree and an income of more = 220, 39.4%) knew that only female Aedes
than Rp. 4,000,000. About 59.9% and mosquitoes bite humans and 46.2% (n =
58.7%, 81.9% of participants have jobs, and 258) understood that there was no cure for
the majority (75.8%) of participants in this dengue fever. Slightly more than half of the
study had no experience with dengue fever. participants knew that Aedes mosquitoes
Table 1 shows that 93.7% (n = 524) of that bite infected people can spread the
participants answered correctly that dengue virus to other people (n= 343, 61.4%) and
fever is transmitted by mosquitoes. Most of recognized that dengue epidemics only
them (n = 480, 85.9%) knew that dengue occur in the dry season (n= 333, 59.7%).
fever is caused by the Aedes aegypti and

Table 1. Results of knowledge score about dengue fever and Aedes aegypti

Statements No. (%)

Knowledge about dengue and Aedes mosquito
DHF is transmitted by mosquito 524 (93.7)
DHF can be fatal 516 (92.3)
Dengue Fever may become Dengue Hemorrhagic Fever 507 (90.7)
DHF is a viral infection 500 (89.4)
An individual can only get dengue once 486 (86.9)
DHF outbreaks occurs only during rainy season 495 (88.6)
DHF is transmitted by the Aedes aegypti and Aedes albopictus mosquitoes 480 (85.9)
Aedes mosquito has black and white stripes on its leg and body 488 (87.3)
Aedes mosquitoes breed in clean stagnant water 424 (75.8)
Aedes mosquitoes bite during dusk and dawn 301 (53.8)
Aedes mosquitoes prefer to live in shaded areas 274 (49.0)
Only female Aedes mosquitoes bite humans 220 (39.4)
Knowledge about the transmission of dengue
Dengue fever usually appear 4-7 days after being bitten 502 (89.8)
Transmission from an infected person by touch 424 (75.8)
Transmission from an infected person by air 404 (72.3)
An individual only can get dengue fever once 408 (73.0)
Transmission from an infected person by body fluids 390 (69.8)
Transmission from an infected person blood 434 (77.6)
Aedes mosquito biting an infected person can spread it to another 343 (61.4)
Dengue epidemic only occurs during dry season 333 (59.7)
Aedes mosquito eggs can contain dengue virus 318 (56.9)
Knowledge of Signs and Symptoms of dengue hemorrhagic fever
Small red or purple spots under the skin 463 (82.8)
Severe headache or fainting 450 (80.5)
Bleeding in gums 437 (78.2)
Bleeding in the nose 388 (69.4)
Shortness of breath 276 (49.4)
Blood in stool and urine 255 (45.6)
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Statements No. (%)

Knowledge of Signs and Symptoms of dengue fever
Headaches 495 (88.6)
Chills 431 (77.1)
High fever for 5-7 days 476 (85.2)
Joint, muscle pain and rash 468 (83.7)
Nausea and vomiting 347 (62.1)
Pain in the eyes 320 (57.2)
Knowledge of prevention practices for dengue
Periodically emptying or drying out containers that retain water around the 528 (94.5)
house
Covering water containers 518 (92.7)
Weekly change of stored water 525 (93.9)
Proper disposal of items that can retain water 501 (89.6)
Apply larvicide treatment in water containers 449 (80.3)
Knowledge of treatment, curability, precautionary measures for dengue
No medication for dengue treatment 258 (46.2)
Only immediate treatment can prevent complications and death 510 (91.2)
There is a vaccine to prevent dengue fever 288 (51.5)
Information : n = 559
DHF = Dengue Hemorrhagic Fever

Table 2 shows a multivariate logistic regression analysis, highlighting that participants

aged over 40 years were more likely (OR=30.908, 95% CI 16.490-57.930, P=0.000) to have
better knowledge of dengue fever compared to the 18-24 years and 25- 39 years age groups.
Further, participants who had an educational degree were more likely (OR=4.028, 95% CI
2.226-7.288, P=0.000) to have better knowledge of dengue fever compared to participants who
did not achieve an educational degree. Participants who worked as private employees or were
self-employed were less likely (OR=0.235, 95% CI 0.098-0.560, P=0.001 and OR= 0.262, 95%
CI 0.107-0.638, P=0.003) to have better knowledge of dengue fever compared to those who
worked as government employees. Participants with an average monthly household income of
more than IDR 4,000,000 were more likely (OR=2.75, 95% CI 1.318-3.928, P=0.003) to have
better knowledge of dengue fever compared to participants who had an income of less than
IDR 4,000,000. Meanwhile, participants who had experienced dengue fever had a higher
likelihood (OR=3.140, 95% CI 1.484-6.640, P=0.003) to demonstrate better knowledge of
dengue fever compared to participants who had never had dengue fever.

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Table 2. Univariate, Bivariate and multivariate analysis between sociodemographic status

and knowledge

Knowledge

Sociodemographic Univariate Bivariate Multivariate logistic regression

Status n (%) Low Score High Score p-value P and OR (95% CI)
(0-28) (29-41)
n (%) n (%)
Gender
Male 312 (55,8) 188 (60.3) 124 (39.7) 0.057
Female 247(44,2) 169 (68.4) 78 (31.6)
Age
18-24 years 122 (21,8) 104 (85.2) 18 (14.8) 0.000
25-39 years 273 (48,8) 229 (83.9) 44 (16.1) 0.000 (20.772) 9.780-44.116
³ 40 years 164 (29,3) 24 (14.6) 140 (85.4) 0.000 (30.908) 16.490-57.930
Tribes
Sundanese 228 (40,8) 147 (64.5) 81 (35.5) 0.993
Javanese 139 (24,9) 89 (64.0) 50 (36.0)
Malay 93 (16,6) 58 (62.4) 35 (37.6)
Batak 60 (10,7) 39 (65.0) 21 (35.0)
Betawi 39 (7,0) 24 (61.5) 21 (38.5)
Level of Education
No formal education 224 (40,1) 191 (85.3) 33 (14.7) 0.000
Primary education 335 (59,9) 166 (49.6) 169 (50.4) 0.000 (4.028) 2.226-7.288
Occupation
Government employee 122 (21,8) 51 (41.8) 71 (58.2) 0.000
Private employee 117 (20,9) 69 (59.0) 48 (41.0) 0.001 (0.235) 0.098-0.560
Self-employed 89 (15,9) 54 (60.7) 35 (39.3) 0.003 (0.262) 0.107-0.638
Farmer 59 (10,6) 38 (64.4) 21 (35.6) 0.252 (0.564) 0.212-1.503
Laborer 71 (12,7) 56 (78.9) 15 (21.1) 0.179 (0.482) 0.166-1.396
Housewife 101 (18,1) 89 (88.1) 12 (11.9) 0.059 (0.354) 0.121-1.038
Income
< IDR 4,000,000 231 (41,3) 170 (73.6) 61 (26.4) 0.000
³ IDR 4,000,000 328 (58,7) 187 (57.0) 141 (43.0) 0.003 (2.275) 1.318-3.928
Experience of dengue fever
No 424 (75,8) 247 (58.3) 177 (41.7) 0.000
Yes 135 (24,2) 110 (81.5) 25 (18.5) 0.003 (3.140) 1.484-6.640

Table 3 reported multivariate logistic regression analysis results and showed that
participants aged 25-39 years were more likely (OR=18.163, 95% CI 16, 8.056-40.947,
P=0.000) to practice dengue fever prevention compared with participants aged 18-24 years.
Participants who had an educational degree were more likely (OR=6.217, 95% CI 3.793-
10.191, P=0.000) to practice dengue fever prevention compared to participants who did not
have an educational degree. Further, participants who worked as housewives were less likely
(OR=0.286, 95% CI 0.129-0.634, P=0.002) to practice dengue fever prevention compared to
participants who had other jobs. Participants who had experienced dengue fever were less
likely (OR=0.271, 95% CI 0.144-0.510, P=0.023) to practice dengue fever prevention
compared to participants who never had dengue fever. Meanwhile, participants who had high
knowledge were more likely (OR=4.037, 95% CI 2.201-7.406, P=0.000) to practice dengue
fever prevention compared to participants with less knowledge.

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Table 3. Univariate, Bivariate and multivariate analyses between sociodemographic status,

knowledge and practice of DHF prevention

Prevention Practices
Univariate Bivariate Multivariate logistic
Sociodemographic regression
Status n (%) Low Score High Score p-value P and OR (95% CI)
(0-43) (44-72)
n (%) n (%)
Gender
Male 312 (55,8) 144 (46.2) 168 (53.8) 0.924
Female 247(44,2) 113 (45.7) 134 (54.3)
Age
18-24 years 122 (21,8) 92 (75.4) 30 (24.6) 0.000
25-39 years 273 (48,8) 143 (52.4) 130 (47.6) 0.000 (18.163) 8.056-40.947
³ 40 years 164 (29,3) 22 (13.4) 142 (86.6) 0.024 (2.158) 1.109-4.200
Tribes
Sundanese 228 (40,8) 113 (49.6) 115 (50.4) 0.415
Javanese 139 (24,9) 66 (47.5) 73 (52.5)
Malay 93 (16,6) 40 (43.0) 53 (57.0)
Batak 60 (10,7) 23 (38.3) 37 (61.7)
Betawi 39 (7,0) 15 (38.5) 24 (61.5)
Level of Education
No formal education 224 (40,1) 115 (69.2) 69 (30.8) 0.000
Primary education 335 (59,9) 102 (30.4) 233 (69.6) 0.000 (6.217) 3.793-10.191
Occupation
Government employee 122 (21,8) 42 (34.4) 80 (65.6) 0.000
Private employee 117 (20,9) 50 (42.7) 67 (57.3) 0.720 (0.882) 0.445-1.751
Self-employed 89 (15,9) 37 (41.6) 52 (58.4) 0.478 (0.787) 0.406-1.525
Farmer 59 (10,6) 22 (37.3) 37 (62.7) 0.295 (0.680) 0.330-1.400
Laborer 71 (12,7) 38 (53.5) 33 (46.5) 0.022 (0.385) 0.170-0.870
Housewife 101 (18,1) 68 (67.3) 33 (32.7) 0.002 (0.286) 0.129-0.634
Income
< IDR 4,000,000 231 (41,3) 110 (47.6) 121 (52.4) 0.570
³ IDR 4,000,000 328 (58,7) 147 (44.8) 181 (55.2)
Experience of dengue fever
No 424 (75,8) 74 (54.8) 61 (45.2) 0.023
Yes 135 (24,2) 183 (43.2) 241 (56.8) 0.000 (0.271) 0.144-0.510
Knowledge
Low Score 357 (64,9) 224 (62.7) 133 (37.3) 0.000
High Score 202 (36,1) 33 (16.3) 169 (83.7) 0.000 (4.037) 2.201-7.406

DISCUSSION to increase in Indonesia due to various

factors. These include failure to control
Dengue fever is a viral infection Aedes mosquito populations, uncontrolled
transmitted through the bite of an infected urbanization, unprecedented population
mosquito that can cause morbidity, growth, and climate variations.26,27 This
hospitalization, and, in some cases, present study also informs that the
death.24,25 The spread of dengue is expected preventive action most preferred by
participants is periodically emptying or
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drying out containers that retain water knowledge of mosquito vectors and the
around the house such as bathtubs, jugs, signs and symptoms of dengue fever is very
water towers, drums and other water important for identifying this disease and
reservoirs (76.5%), and applying larvicide implementing appropriate preventive
treatment and other mosquito repellents measures to reduce the incidence of this
(70.8%). The application of mosquito-proof disease.31 These results confirm the
nets will not be effective in preventing outcomes of studies reported in Malaysia,10
Aedes mosquito bite incidents because most India,32 Nepal,33 and Thailand.34
mosquito-proof nets are only used at It is essential to note that based on
night.28 The present findings show that multivariate analysis, people aged over 40
more than half (55.2%) of the participants years are more likely to have better
responded that clearing and repairing knowledge of dengue fever. This
clogged drains and gutters to prevent water relationship is consistent with what has
from accumulating could be a preventive been observed in other studies.35 In
measure. This finding supports a previous addition, with increasing age, there is an
study where more than half (55.7%) of the increase in the frequency of positive
participants mentioned environmental attitudes and practices to control
cleaning as an important preventive transmission. Other findings from China
practice.29 suggest that age is directly associated with
Surprisingly, in this study, although certain knowledge about the disease and its
most participants had high knowledge transmission mechanisms.36
about the Aedes mosquito and dengue Another important finding is that
fever, only a small portion of them carried participants with a higher level of education
out preventive measures and practiced had much higher knowledge scores.
controlling the Aedes aegypti mosquito Previous studies showed that the level of
breeding. The key finding of this study is education has a significant influence on
that the good practice level was lower than knowledge related to dengue fever.37,38
the knowledge level although there was a These findings indicate that knowledge
significant relationship existing between about dengue fever is relatively low among
knowledge and preventive practices. These people with low education. Therefore, more
findings on the level of practice are similar effective education programs to increase
to a previous study which reported high public awareness need to be implemented
levels of knowledge but low levels of among societies with low levels of
practice.30 In fact, if the gap between education, especially in large cities with
knowledge and practice is not decreased, high population density where dengue fever
this will become an important challenge in dominates. This present study also revealed
controlling dengue fever and Aedes aegypti that participants with incomes above IDR
populations. 4,000,000 had higher knowledge levels.
This study found that age, level of This may be because people with higher
education, occupation, household income, economic status may have better access to
and previous experience with dengue fever sources of information about dengue
were significantly associated with fever.39
participants’ knowledge about dengue At the same time, participants who
fever. The results of this investigation show had experienced dengue fever had
that the majority of participants have significantly higher knowledge scores. This
knowledge about the concept of dengue may be because they actively seek
fever, the morphological characteristics of information when facing the disease or
Aedes aegypti, modes of transmission, and receive information from health workers
suitable habitats for this mosquito. Good while undergoing treatment. These findings

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are consistent with those observed in Puerto there may be a bias towards the desired
Rico where individuals previously responses and behaviours.
diagnosed with dengue fever were more
knowledgeable about dengue fever and CONCLUSION AND
were concerned about others contracting RECOMMENDATIONS
it.40
Based on the findings of this study, From this study, several conclusions
it is suggested that dengue fever prevention could be inferred, firstly, this study
should be emphasised through effective highlights that the majority of participants
education programmes, and public health have a high level of knowledge about the
promotion initiatives by health officials concept of dengue fever, the morphological
should be conducted especially in densely characteristics of Aedes aegypti, modes of
populated areas focusing on dengue fever transmission, and suitable habitats for this
transmission, Aedes mosquito breeding mosquito. Secondly, age, education,
sites, early diagnosis of dengue fever and occupation, household income, and
treatment procedures. Policymakers have previous experience with dengue fever are
the opportunity to design steps to increase significantly associated with knowledge
awareness, understanding and surveillance about this disease. Thirdly, dengue fever
through the use of community-based prevention practices can be influenced by
education initiatives. The Government of the level of knowledge and
Indonesia should also provide and train an sociodemographic status (age, education,
adequate number of health workers to occupation, and experience with dengue
deliver appropriate counselling in an effort fever). Therefore, it is suggested that
to bring about community behaviour dengue fever prevention should be
change and encourage dengue prevention emphasised through effective education
practices. In addition, continuous education programmes and public health promotion
and monitoring should be conducted to efforts by health officials should be
ensure long-term behaviour change towards conducted, especially in densely populated
successful dengue prevention.30 areas. Moreover, the Government of
There are several strengths to our Indonesia should also provide and train an
study. Firstly, the researchers conducted the adequate number of health workers to
research study in a dengue endemic deliver appropriate counselling, in an effort
location. Second, the researchers used a to bring about community behaviour
randomised sample to reduce selection bias. change and encourage dengue prevention
Third, the researchers used a questionnaire practices.
that has been proven to be consistent, hence
the information obtained in this study can
ACKNOWLEDGMENTS
describe the actual level of knowledge and
practice of dengue prevention. Limitations
The author would like to thank the
of this study include the fact that it was
Bhakti Kencana University for providing
conducted in one city and most of the
support so that this research can be carried
participants were Sundanese. This may not
out as expected.
be representative of all Indonesians, hence
making generalisation of the results
difficult. All information obtained from the
interviews was self-reported, therefore

35
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Vol.22 No.2 May-August 2024

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