Abstract
BackgroundDengue is an emerging vector disease with frequent outbreaks in Nepal that pose a major threat to public health. Dengue control activities are mostly outbreak driven, and still lack systematic interventions while most people have poor health-related knowledge and practices. Mobile Short Message Service (SMS) represents a low-cost health promotion intervention that can enhance the dengue prevention knowledge and practices of the affected communities. This study aimed to explore the acceptability, appropriateness, and effectiveness of mobile SMS intervention in improving dengue control practices.MethodsThis study was an implementation research that used mixed-methods design with intervention. A total of 300 households were divided into three groups, i.e. one control group, one dengue prevention leaflet (DPL) only intervention group and one DPL with mobile SMS intervention group (DPL + SMS). We used a structured questionnaire to collect information regarding participants’ knowledge and practice of dengue prevention. We conducted in-depth interviews with key informants to measure acceptability and appropriateness of intervention. Mean difference with standard deviation (SD), one-way ANOVA, paired t-test and regression analyses were used to assess the effectiveness of the interventions. Thematic analysis was used to assess the acceptability, and appropriateness as well as barriers and enablers of the intervention.ResultsThe DPL + SMS intervention produced significantly higher mean knowledge difference (32.7 ± 13.7 SD vs. 13.3 ± 8.8 SD) and mean practice difference (27.9 ± 11.4 SD vs 4.9 ± 5.4 SD) compared to the DPL only group (p = 0.000). Multivariate analysis showed that the DPL + SMS intervention was effective to increase knowledge by 28.6 points and practice by 28.1 points compared to the control group. The intervention was perceived as acceptable and appropriate by the study participants and key stakeholders. Perceived barriers included reaching private network users and poor network in geographically remote areas, while enabling factors included mobile phone penetration, low cost, and shared responsibility.ConclusionsMobile SMS is an effective, acceptable and appropriate health intervention to improve dengue prevention practices in communities. This intervention can be adopted as a promising tool for health education against dengue and other diseases.
Highlights
Dengue is an emerging vector disease with frequent outbreaks in Nepal that pose a major threat to public health
This study is the first of its kind in Nepal to compare the difference in effectiveness of conventional health promotion media alone and interventions combining those with mobile Short Message Service (SMS) on knowledge and practice towards dengue prevention
Acceptability and appropriateness of mobile SMS intervention This study reveals that the respondents perceived mobile SMS as a highly acceptable media for receiving dengue preventive messages to improve their existing knowledge and practice
Summary
Dengue is an emerging vector disease with frequent outbreaks in Nepal that pose a major threat to public health. Dengue control activities are mostly outbreak driven, and still lack systematic interventions while most people have poor health-related knowledge and practices. Dengue is a fast emerging pandemic-prone viral disease identified as a major public health concern globally [1]. It is a rapidly emerging public health threat in Nepal, where the earliest cases were reported in 2005 with sporadic cases continuing with occasional major outbreaks [2]. The country-wide distribution of dengue fever cases was highly clustered around several districts, especially Chitwan and Jhapa, and showed high inter-annual and seasonal variation [6]
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