Abstract
Geographic pattern of dengue fever is changing due to the global environmental and climate changes in the 21st century. Evidence of community’s knowledge, mosquito bite patterns and protective behavior practices in non-endemic regions is limited. This study examined the knowledge of dengue, mosquito bite patterns, protective behavior practices and their associated factors in Hong Kong, a non-endemic subtropical city. A population-based random telephone survey (n = 590) was conducted three weeks after the government announcement of a local dengue outbreak in August 2018. Sociodemographic status, awareness, knowledge, protective measures, bite patterns of mosquito were collected. Results indicated high level of community awareness of the local outbreak (95.2%), symptom identification (84.0%) and adoption of at least one mosquito protective measures (nearly 80%). About 40% of respondents reported that they were bitten by mosquitoes during the study period, a high mosquito season in Hong Kong. Mosquito bites were prevalent near grassy area (63.4%), at home (42.6%) and at public transportation waiting spots (39.6%). Younger people (< 25 years old), female, those who lived on lower floors (≤the 6th) and near grassy area were at higher risk of mosquito bites at home. Respondents perceived higher threat of dengue to society were more likely to practice mosquito prevention. While residential factors affected their indoor prevention, other socio-demographic factors affected the outdoor prevention. Practicing prevention behaviors were associated with self-reported mosquito bite at home. Furthermore, the general prevention uptake rate unchanged after the announcement of local dengue outbreak. Although the uptake rate of protective measures during August was high, 40% participants reported they were bitten. Also public locations are more common area for bites, which suggested stronger mosquito prevention and control on public environments and more personal protective behaviors should be advocated.
Highlights
The global prevalence and trend of dengue feverDengue fever is a mosquito-borne infectious disease with more than 100 tropical and subtropical countries globally reported to be endemic[1] and it was estimated that more than half of the total population were at risk in the world[2]
562 respondents out of 590 (95.3%) reported that they noticed the announcement of local dengue fever outbreak by Hong Kong government in August 2018
For knowledge related to dengue fever, 544 out of 590 (92.2%) understood that dengue fever could be transmitted by mosquitoes and 473 of them (87.6%) correctly indicated that Aedes mosquitoes are the vector of dengue fever
Summary
Dengue fever is a mosquito-borne infectious disease with more than 100 tropical and subtropical countries globally reported to be endemic[1] and it was estimated that more than half of the total population were at risk in the world[2]. Dengue infection is prevalent in Southeast Asia[3] because of the presence of its primary vector Aedes aegypti mosquitos. In regions without this vector, including European and North American areas, imported cases and the potential outbreak are possible due to the existence of a second mosquito vector, Aedes albopictus. Non-endemic communities without preparedness may be under increasing risks of dengue outbreak in response to the climate change catastrophe
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