Abstract
BackgroundGlobally there are an estimated 390 million dengue infections per year, of which 96 million are clinically apparent. In Cambodia, estimates suggest as many as 185,850 cases annually. The World Health Organization global strategy for dengue prevention aims to reduce mortality rates by 50% and morbidity by 25% by 2020. The adoption of integrated vector management approach using community-based methods tailored to the local context is one of the recommended strategies to achieve these objectives. Understanding local knowledge, attitudes and practices is therefore essential to designing suitable strategies to fit each local context.Methods and findingsA Knowledge, Attitudes and Practices survey in 600 randomly chosen households was administered in 30 villages in Kampong Cham which is one of the most populated provinces of Cambodia. KAP surveys were administered to a sub-sample of households where an entomology survey was conducted (1200 households), during which Aedes larval/pupae and adult female Aedes mosquito densities were recorded. Participants had high levels of knowledge regarding the transmission of dengue, Aedes breeding, and biting prevention methods; the majority of participants believed they were at risk and that dengue transmission is preventable. However, self-reported vector control practices did not match observed practices recorded in our surveys. No correlation was found between knowledge and observed practices either.ConclusionAn education campaign regarding dengue prevention in this setting with high knowledge levels is unlikely to have any significant effect on practices unless it is incorporated in a more comprehensive strategy for behavioural change, such a COMBI method, which includes behavioural models as well as communication and marketing theory and practice.Trial registrationISRCTN85307778.
Highlights
With up to 3.9 billion people in 128 countries at risk of the disease, dengue affects most of the world’s tropical and sub-tropical regions and has become the most rapidly spreading mosquito-borne viral disease[1,2]
An education campaign regarding dengue prevention in this setting with high knowledge levels is unlikely to have any significant effect on practices unless it is incorporated in a more comprehensive strategy for behavioural change, such a Communication and Behaviour Impact (COMBI) method, which includes behavioural models as well as communication and marketing theory and practice
In Cambodia it is common for people to marry early
Summary
With up to 3.9 billion people in 128 countries at risk of the disease, dengue affects most of the world’s tropical and sub-tropical regions and has become the most rapidly spreading mosquito-borne viral disease[1,2]. There are an estimated 390 million infections per year, of which 96 million are clinically apparent [3]. In 2015, the first ever dengue vaccine, Dengvaxia (Sanofi-Pasteur), came on the market despite having 60% efficacy and inducing very low protection against DENV-2[4,5]. It will likely be several years before the vaccine is made available in low-income countries such as Cambodia. Due to the lack of a readily available vaccine or therapeutics, vector control is the only means of dengue prevention. There are an estimated 390 million dengue infections per year, of which 96 million are clinically apparent. Understanding local knowledge, attitudes and practices is essential to designing suitable strategies to fit each local context
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