Int J Pharma Res Health Sci.

2018; 6 (1): 2389-93

DOI:10.21276/ijprhs.2018. 2018. 02.09
Catherine Malliga et al. CODEN (USA)-IJPRUR, e-ISSN: 2348-6465

International Journal of Pharma Research and Health Sciences

Available online at www.pharmahealthsciences.net

Original Article

Knowledge, Attitude and Practices on Prevention of

Dengue Fever among Various Groups of People of
Urban Tiruchirappalli
Catherine Malliga S1,*, Geetha Rajasekar1, Vasugi S R2 , Malathi P 3
1*
Lecturer in Medical Entomology, K.A.P.Visvanatham Government Medical College, Tiruchirappalli, India.
1
Assistant Professor of Community Medicine, K.A.P.Visvanatham Government Medical College, Tiruchirappalli, India.
2
Associate Professor and Head [Retd], Department of Zoology, Periyar EVR college, Tiruchirappalli, India.
3
Research Scholar, Department of Zoology, Periyar EVR college, Tiruchirappalli, India.
ARTICLE INFO ABSTRACT

Received: 22 Feb 2018 Back ground: Dengue fever is a major public health problem in India and throughout the tropical
and subtropical regions of the world. More than 70% of the world’s population are at risk for
Accepted: 11 Mar 2018 dengue. Tiruchirappalli is a city located in the middle of the state Tamilnadu, south India. It is one
of the dengue endemic areas with intermittent outbreaks. The knowledge levels of general public
about Dengue fever, modes of spread and prevention was not measured and research done about it
at Tiruchirappalli were limited. Various awareness campaigns had been conducted in the past,
regarding Dengue fever and its transmission. This study was planned to measure the knowledge
about Dengue fever, attitude and practices about its prevention. Objectives: To assess the
knowledge about Dengue fever, attitude and practices on Dengue prevention among various
groups of people at Tiruchirappalli urban area. Experimental approach: A cross sectional study
was conducted from December 2016- May 2017 in four Zones of Tiruchirappalli Corporation. The
study had four groups of participants which included women aged between 25 to 50 years, men
aged between 25 to 50 years, college students between 18 to 25 years and school students between
11 to 18 years. The city had four administrative Zones. From each Zone 100 participants were
selected randomly and totally 400 participated. The data was analysed on SPSS version 18.
Findings and Discussion: The mean knowledge score of school students were 3.02 followed by
______ men 2.41, women 2.27 and college students 1.40 respectively. The school students had the highest
mean knowledge score on Aedes larva breeding sites which was statistically significant than
college students and women with p value <0.001 and 0.010 respectively. The college students had
the less knowledge score than other groups with p values <0.001, 0.002, <0.001 and was
statistically significant. Conclusion: The school students had more knowledge on Aedes larva
breeding sources than other groups.
Key words:
Aedes, Attitude, Dengue, Knowledge, Practice.

1. INTRODUCTION
Dengue fever is a major public health problem in India and
Corresponding author * throughout the tropical and subtropical regions of the world.
Catherine Malliga S, Almost 50% the world’s population are living in dengue
Lecturer in Medical Entomology,
K.A.P. Visvanatham Government Medical College, endemic countries.1 More than 70% of the world’s
Tiruchirappalli. population are at risk for dengue especially South East Asia
Email: [email protected]
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Int J Pharma Res Health Sci. 2018; 6 (1): 2389-93
Region (SEAR) and Western Pacific Region, where 75% of commercial area and 25 women were chosen randomly by
the current global disease burden of dengue exists.2 Dengue systematic random sampling by visiting every 3 rd house in
virus was isolated for the first time in India during 1945 and a randomly chosen residential area. Thus each Zone had 100
the first dengue fever in India was reported in Vellore participants and four Zones totalled to 400 participants.
district in Tamil Nadu during the year 1956. The first major Participants were informed about the study and informed
Dengue Haemorrhagic Fever (DHF) outbreak occurred in consent was obtained. A structured, pretested and self
India at Calcutta (West Bengal) in the year 19633,4. Dengue administered questionnaire was used. It tested the knowledge
Fever (DF) along with its two clinical syndromes , Dengue about Dengue fever, attitude and dengue preventive
Haemorrhage fever (DHF) and Dengue Shock Syndrome practices. The data was entered in EpiData 3.0 software and
(DSS) are the most important arboviral diseases of human analysed on SPSS version 18. Descriptive analysis,
being and it is an important infectious disease in both the proportions for each variable and comparison between
tropical and subtropical regions.5 In South India, all the four groups by students for using chi -square ‘ t ‘ test. This study
serotypes of dengue viruses have been isolated from clinical was approved by the Institutional ethical committee I.E.C.
specimens and also in mosquitoes in Vellore, Tamil Nadu NO. 48/2016 Dated 23.11.2016.
during early 1960s establishing the activity of different
serotypes of dengue in this area.6,7 In Tiruchirappalli the first 3. RESULTS AND DISCUSSION
dengue outbreak occurred during the year 2003.8 From 2003 Among the 400 participants 45.8% were male and 54.3%
onwards dengue cases were being reported and it is an were female.The age ranged from 11 to 50 years. Three
endemic area for dengue fever. The mean numbers of cases percent of the participants had studied up to 5th standard,
from the year 2013 to 2016 were 220 cases per year. The 49.8% of participants had studied from 6 to 10 standard,
knowledge levels of general public about Dengue fever, 3.3% of the participant had studied up to 11 to 12 standard.
modes of spread and prevention was not measured and 43.3% of the participant had studied either degree or
research done about it at Tiruchirappalli were limited. diploma. Only 0.8% of the participants were illiterate.
Various awareness campaigns had been conducted in the Overall 8% of the resided in Kutcha house, 63.8% of them
past regarding Dengue fever and its transmission. This study resided in Pucca house, 23% Residing in Semi Pucca and
was planned to measure the knowledge about Dengue fever, 5.3% lived in other type of houses. Around 56% of
attitude and practices about its prevention. The objective of participants belong to upper middle income group, 15%
the study was to assess the knowledge about Dengue fever, lower middle income group, 28 % belong to upper lower
attitude and practices on Dengue prevention among various income group and 1% belong to lower income group
groups of people in Tiruchirappalli urban area. according to modified Kuppusamy socio economic scale for
Urban area 2016(Table I).
2. MATERIALS AND METHODS About 80% of college students and 93% of school students,
This cross sectional study was conducted from December 76% of women and 72% of men knew dengue as one type of
2016 to May 2017 at Tiruchirappalli urban area. Assuming fever among all fevers (Table II). Among the study
50% knowledge among general public about Dengue, the participants 80% college students, 89% of school students,
sample size was arrived at 400 people with 5% precision 93% of women and 94.9% of men said that they knew about
with formula 4PQ/d2. Adults and children between the age dengue fever. Dengue fever as a viral disease was known to
groups of 11 to 50 years were included in the study. The 42% of college students, 39% of school students, 50% of
physically handicapped individuals who had speech and women and 46% of men. The knowledge that the bite of the
hearing disabilities were excluded from the study. The study mosquito transmits dengue fever was known to 49% of
population consisted of four groups which were school college students, 53% of school students, 81% of the women
students between 11 to less than18 years, college students and 76% of men. The knowledge about the name of the
between 18 to less than 25 years, men between 25 to 50 mosquito transmitting Dengue was known to 14% of college
years and women between 25 to 50 years of age students, 59% of school students, 59% of women and 72%
respectively. Tiruchirappalli urban area has four of men. Regarding the availability of treatment for Dengue
administrative Zones namely Abishekapuram, Ponmalai, fever 73% of college students, 74% of school students, 74%
Srirangam and Ariyamangalam respectively. One school, of women and 83% of men knew that there is specific
one college and one ward (Corporation administrative units) treatment for Dengue fever and 16% of college students,
were chosen from each Zone by stratified random sampling. 31% of school students, 64% of women and 55% of men
Thus four schools, four colleges and four wards were chosen knew that there is no vaccine available for prevention of
in total. From each school 25 students were chosen randomly Dengue fever.
and the questionnaire was administered. Similarly from each The knowledge levels on Aedes larva breeding sites showed
college 25 students were chosen randomly and questionnaire that 33%,44%,60%and 57% of college, school, women and
was administered. 25 men were chosen by systematic men knew that Aedes larvae breeds in clean water
random sampling by visiting every 3 rd shop/office in a respectively where as 45%, 34%,5%and 7% said that Aedes
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IIIIIIIII© International Journal of Pharma Research and Health Sciences. All rights reserved
Int J Pharma Res Health Sci. 2018; 6 (1): 2389-93
larva breeds in drainage (dirty) water. About 20% of college, concerned households, 6.8% believed it as the responsibility
21% of school students, 34% of women and 32% of men of the government and 0.8% believed it to be the
knew that Aedes larva breeds in artificial containers having responsibility of volunteers (Table IV)
water. The knowledge on time of bite of Aedes mosquito The knowledge scores of the four groups of participants
was assessed and it was found that 77%, 74%, 59% and 65% were compared. The maximum score was 7 and the
of college, school students, women and men thought that minimum was zero. The mean score of school students was
Aedes mosquito bites at night time alone where as 3.02 followed by men 2.41, women 2.27 and college
23%,6%,2% and 2% of college, school students, women and students 1.40 respectively. The school students had the
men thought that Aedes mosquito bites during day time highest mean knowledge score on Aedes larva breeding sites
alone. 20% of school students, 39% of women and 33% men which was statistically significant on comparison of means
thought that Aedes mosquito bites both day and night times. by Bonferoni test than college students and women with p
The knowledge about prevention of Dengue mosquito value <0.001 and 0.010 respectively(Table V). The college
breeding was assessed and 52% of college students thought students had the less knowledge score than other groups with
fogging activities to be the best way to do it, whereas 60%, p values <0.001, 0.002,<0.001 and was statistically
72% and 81% on school students, women and men thought significant. The mean knowledge score of women and men
prevention of water stagnation around the house was the best were more than college students and statistically significant
way to do it (Table II). with p value of 0.002 and <0.001 respectively (Table V).
The participants were asked to identify potential dengue The knowledge about Dengue as a disease with fever as a
breeding sites from a list of 9 items. Each rightly identified symptom, a viral disease and mosquito being the
item had a score of one. Among the nine items two items transmitting agent was more among women, men and school
had negative scoring. The final scores were calculated and students. These are similar to other studies done at Kuala
was decided that those having a score of three and above had during 20039. Among the women participants in the present
good knowledge on Aedes larva breeding sites. Among the study, 81% knew that Dengue is a mosquito transmitted
college students 14% had scores three and above which was disease and 59% knew that Aedes mosquito transmits it. In a
53% in school students, 33% in women and 40% in men similar to a study done at Kanchipuram,Tamilnadu 89% of
respectively. Among the four groups of participants the participants knew about it and the womens knowledge levels
school students had good knowledge followed by men, were unknown10. Regarding the knowledge on vaccine
women and college students. (Table II) availability 55% of men and 64% of women knew that there
Out of 400 participants 335 (83.8%) obtained drinking is no vaccine for Dengue which is better than a similar study
water from corporation water supply, 35 (8.8%) from bore done at Sindh where only 45.7% knew about it11. The
well, 12 (3%) from wells, 13 (3.3%) from plastic water college students harboured misconceptions like Aedes larva
containers and 2 (0.5%) from water lorries.(Table 3) Out of breeds in dirty/drainage water, Aedes mosquito bites at night
400 respondents 378 (94.5%) of them store water, out of time only than other groups. This could be because the
which 341 (90.2%) of them said that they closed their water health education programmes and other mass media
storage containers with lids. In addition out of 378 people activities would not have reached the college students. The
who stored water, 147 (38.9%) of them said that they mean knowledge score on Aedes larva breeding sites were
cleaned their containers daily, 92 (24.3%) of them once in 3 more among school students followed by men, women and
days, 121 (32%) weekly, 12 (3.2%) clean once in a month, college students. This could be because that the urban area in
and 2 (0.5%) cleaned their container only during the next which the study was done had Dengue outbreaks on the past
supply of water. (Table III) and the schools had the health education programmes by
All 400 participants were asked about the measures they district health authorities and the students were involved in
adopt to prevent Aedes larval breeding and 55.8% of them source reduction activities. The women and men are better
said that they closed their water containers with lid, 32.5% knowledged than college students on Dengue fever and this
of them cleaned their containers with bleaching powder, could be due to their age and exposure to mass media.
10% of them observed dry day once a week and 1.8% of Though the knowledge is more the household environment
them did not take any measures. Regarding personal seems to be conducive for Aedes larval breeding. The pit
prophylactic measures out of 400 participants 52.3% of them taps and sumps where most of the population (n=335, Table
used mosquito coils, 24.5% used creams, 23% used IV) receive water from piped supplies are potential water
vaporizers, and other methods like window netting are 0.3%. stagnation points. The water stagnation in public pit taps on
Regarding environment favouring water stagnations, 68.5% streets are mostly not cleaned frequently and kept dry. The
of participants had piped line supply from corporation water is stored by 94.5% of the study participants which
through pit taps on streets and 15.3% of participants received shows their interrupted water supply. Although 90.2% of
piped line supply through sumps. When queried about the them said that use lids to cover the water storage containers
responsibility of keeping the surroundings clean, out of 400 this study was not equipped to cross verify it and around
participants 92.3% believed it as the responsibility of the 10% said that they don’t use lids for water storage
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Int J Pharma Res Health Sci. 2018; 6 (1): 2389-93
containers. Cleaning the water containers entirely plays an Know that Dengue
important role in breaking the Aedes larva life cycle but only mosquito bites during day 23% 6% 2% 2%
time
39% of participants cleaned it daily, 24.3% cleaned it once Know that Dengue
in three days and 37% cleaned it less frequently. This could mosquito bites during 77% 74% 59% 65%
serve as a potential source of Aedes mosquitoes inside the Night time
household. All the participants said that they use personal Know that Dengue
mosquito bites during both 0% 20% 39% 33%
protective measures like repellent creams, coils and
day and night time
vaporizers. There exists a favourable attitude towards the Fogging
52 (52%) 9 (9%) 7 (7%) 7 (7%)
responsibility of keeping the surroundings clean as 92.3% of activities
the participants said that it is the responsibility of concerned Source
reduction 43 (43%) 15(15%) 0 (0) 1(1%)
households. This attitude could be harboured to develop Knowledge
activities
community participation in activities involving Dengue about
Applying
prevention of
prevention. larvicides in 4 (4%) 16(16%) 21(21%) 11(11%)
Dengue
Table 1: Socio Demographic Characteristics n=400 (n=number) water
Mosquito
Gender Male 183 (45.8%) Preventing
breeding
Female 217 (54.3%) water
stagnation 1(1%) 60 (60%) 72 (72%) 81(81%)
around the
Education level Illiterate 3 (0.8%)
house
Up to 5 th std 12 (3%)
Good knowledge
6th to 10th std 199 (49.8%) (score of 3 and above on
11 th to 12 th std 13 (3.3%) 14(14%) 53 (53%) 33 (33%) 40 (40%)
Dengue breeding sites
Degree/diploma 173 (43.3%) identification)
Housing Kutcha 32 (8%)
Pucca 255 (63.8%) Table 3: Water and its storage practices n=400(Number = n)
semi Pucca 92 (23%) Source of drinking water Corporation 335 (83.8%)
Others 21 (5.3%) (n=400) Bore well 35 (8.8%)
Socio economic status High income group 0 Well water 12 (3%)
Lorry water 2(0.5%)
Upper middle income group223 (55.8%)
Can water 13 (3.3%)
Lower middle income 60(15%)
others 3 (0.8%)
group
Water storage Practices Present 378 (94.5%)
Upper lower income group 113 (28.3%)
(n=400) Absent 22 (5.5%)
Lower income group 4(1%)
Using Lid for water Yes 341 (90.2%)
storage containers no 37 (9.8%)
Table 2 : Knowledge about Dengue fever (n=378)
House Time interval of cleaning Daily 147 (38.9%)
College School Men aged water containers (n=378) Once in three days
wives aged 92 (24.3%)
students students 25 to 60
25 to 60 Once in a week 121 (32%)
n=100 n=100 yrs n=100
yrs n=100 Once in a month 12 (3.2%)
Know Dengue as one of the During next water supply 2 (0.5%)
80(80%) 93(93%) 76(76%) 72(72%) unknown 4 (1.1%)
various fevers
Measures adopted to Closing containers with 223 (55.8%)
Said that they know about
80(80%) 89(89%) 93(93%) 94(94%) prevent Dengue larval tight lid
Dengue
breeding Cleaning with bleaching 130 (32.5%)
Know that Dengue is due to n=400 powder
42 (42%) 39 (39%) 50 (50%) 46 (46%)
a Virus Observe dry day once a 40 (10%)
Know that mosquito bite week
49(49%) 53(53%) 81(81%) 76(76%)
transmit Dengue No measures taken 7(1.8%)
Know the name of the Personal protective Creams 98 (24.5%)
14 (14%) 59 (59%) 59 (59%) 72 (72%)
mosquito measures Coils 209 (52.3%)
Know that specific n=400 Vaporizers 92 (23%)
treatment available for 73(73%) 74(74%) 74(74%) 83(83%) others 1(0.3%)
Dengue
Know that there is no
16(16%) 31(31%) 64(64%) 55(55%) Table 4: Environment favoring water stagnation n=335*
vaccine for Dengue
Piped supply through pit taps 274 (68.5%)
Said that Aedes larva
33 (33%) 44 (44%) 60 (60%) 57 (57%)
breeds in clean water Piped supply through sumps 61 (15.3%)
Said that Aedes larva
45% 34% 5% 7%
breeds in drainage water Attitude towards clean surroundings n=400
Said that Aedes mosquito The responsibility lies with 27 (6.8%)
breeds in artificial 20 (20%) 21 (21%) 34 (34%) 32 (32%) Government
containers with water Concerned 369 (92.3%)

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Int J Pharma Res Health Sci. 2018; 6 (1): 2389-93
households 3 (0.8%) 6. Carey DE, Myers RM and Reuben R. 1964. Dengue
Volunteers
Others 1 (0.3%)
Types –1 and 4 Viruses in wild caught mosquitoes in
*Those who do not have water source at homes south India, Science, 143 : - 131 – 132.
7. Myers RM, Carey DE, Rodrigues FM and Klontz
CE.1964. The isolation of dengue type 4 virus from
Table 5: Comparison of knowledge scores on Aedes larva breeding
sources
human sera in South India. Indian J Med Res, 52: 559 –
Groups In comparison Mean P value 565.
Mean score (SD) with difference 8. T. John Victor, S. Sridharan , S. Catherine Malliga ,
School students College students 1.620 <0.001* M.Malathi , D. Senguttuvan , R . Asokan , D. Et
3.02 (1.94) House wives 0.750 0.010*
al.Investigation on the Dengue fever out break during
Men 0.610 0.062
College students School students -1.620 <0.001*
2003 in Tiruchirappalli, Tamilnadu. J of Vector Borne
1.40 (1.33) House wives -0.870 0.002* Diseases: Epidemiology and control: ICMR Chapter
Men -1.010 <0.001* 6:45-54
Housewives College students 0.870 0.002* 9. Farizah Hairi, Cyril HS, Anwar Suhaimi, Teoh – Wei
2.27 (1.66) School students -0.750 0.010*
Tsung, Mohd Azhar bin Anis Ahmad, Charlotte
Men -0.140 1.000
Men College students 1.010 <0.001*
Sundaraj et al. A Knowledge, Attitude and Practices
2.41 (1.68) School students -0.610 0.062 (KAP) study on Dengue among selected Rural
Housewives 0.140 1.000 Communities in Kuala Kangsar District Asia – Pacific
*Statistically significant Journal of public Health 2003 Vol 15 No.1.
10. Vinoth Gnana Chellaiyan , Aravind Manoharan, Murali
Ramachandran , Knowledge and awareness towards
4. CONCLUSION dengue infection and its prevention : a cross sectional
The knowledge about Dengue fever was good among school study from rural area of Tamil Nadu, India. Int .
students, women and men than college students. Attitudes J.Community Med Public Health. 2017 Feb; 4 (2) : 494
towards to keeping their surroundings also good, however it – 499.
was found that the good knowledge and attitudes does not 11. Rafaquat Bota, Mushtaq Ahmed, Muhammad salah
necessarily lead to good practice. Health education Jamali, Adan Aziz. Knowledge, Attitude and perception
programme should be continued and intensified with regarding dengue fever among university Students of
emphasis on college students and young adults. interior Sindh. Journal of Infection and Public Health
(2014)7,218-223.
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