Abstract
BackgroundComprehensive understanding of risk factors related to socio-economic and demographic status and knowledge, attitudes and practices (KAP) of local communities play a key role in the design and implementation of community-based vector management programmes, along with the identification of gaps in existing control activities.MethodsA total of 10 Medical Officers of Health (MOH) areas recording high dengue incidence over the last five years were selected from Colombo (n = 5) and Kandy (n = 5) Districts, Sri Lanka. From each MOH area, 200 houses reporting past dengue incidence were selected randomly as test group (n = 1000 for each district) based on the dengue case records available at relevant MOH offices. Information on socio-economic and demographic status and knowledge, attitudes and practices were gathered using an interviewer administered questionnaire. The control group contained 200 households from each MOH area that had not reported any dengue case and the same questionnaire was used for the assessment (n = 1000 for each district). Statistical comparisons between the test and control groups were carried out using the Chi-square test of independence, cluster analysis, analysis of similarities (ANOSIM) and multi-dimensional scaling (MDS) analysis.ResultsSignificant differences among the test and control groups in terms of basic demographic and socio-economic factors, living standards, knowledge, attitude and practices, were recognized (P < 0.05 at 95% level of confidence). The test group indicated similar risk factors, while the control group also shared more or less similar characteristics as depicted by the findings of cluster analysis and ANOSIM. Findings of the present study highlight the importance of further improvement in community education, motivation and communication gaps, proper coordination and integration of control programmes with relevant entities. Key infrastructural risk factors such as urbanization and waste collection, should be further improved, while vector controlling entities should focus more on the actual conditions represented by the public on knowledge, attitudes and personal protective practices.ConclusionsThe design of flexible and community friendly intervention programmes to ensure the efficacy and sustainability of controlling dengue vectors through community based integrated vector management strategies, is recommended.
Highlights
Comprehensive understanding of risk factors related to socio-economic and demographic status and knowledge, attitudes and practices (KAP) of local communities play a key role in the design and implementation of community-based vector management programmes, along with the identification of gaps in existing control activities
Study design: selection of locations Colombo District (6.70° to 6.98°N and 79.83° to 80.22°E), the commercial capital of Sri Lanka, accounted for approximately 18.42% (n = 34,274) of the dengue cases reported from Sri Lanka in 2017 and is the most high-risk area for dengue incidence in Sri Lanka [5]
The five most high-risk Medical Officers of Health (MOH) areas that have reported the highest number of dengue cases during 2010–2016, were selected as the study areas in each district
Summary
Comprehensive understanding of risk factors related to socio-economic and demographic status and knowledge, attitudes and practices (KAP) of local communities play a key role in the design and implementation of community-based vector management programmes, along with the identification of gaps in existing control activities. The number of countries reporting dengue epidemics on a regular basis has increased from nine in 1970 to more than 128 countries within the past four decades, making dengue fever the most rapidly spreading mosquito-borne viral disease in the world [2]. Similar to many Asian countries, a complex interplay of multiple factors, e.g. urbanization, sanitation, mosquito control, meteorological, environmental, biological and demographic factors, results in dengue occurrence and transmission. Studying these factors is important in recognizing significant spatial and temporal trends of dengue outbreaks in any country [4, 6,7,8]. The relative importance of each factor on epidemic incidence and geographical distribution of epidemics may vary from one country to another, depending on the specific climatic, environmental, socio-cultural and economic conditions [9]
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