Dengue Research Articles

Descriptive study on knowledge, attitude and practice regarding dengue fever and its vector control in Aligarh

Background: In the past decade, there was a substantial increase in dengue burden on health services and economy of the nation. UP is endemic to dengue fever (DF) with cases being reported throughout the year. Methods: Between February 2022 and May 2022, an epidemiological survey was conducted in 192 households (HHs) randomly selected from all field practice areas affiliated with urban health training centre (UHTC) and rural health training centre (RHTC) of the department of community medicine, Jawaharlal Nehru medical college, Aligarh. Knowledge, attitude, and practice (KAP) were assessed by means of a pre-tested and structured questionnaire. Results: As per Bloom’s cut-off criteria, it was identified that about 85.9% of the participants had poor level of knowledge, 83.3% had neutral attitude and 50.5% had poor level of practice regarding DF and its vector control. Conclusions: There was a lack of in-depth knowledge regarding DF and its vector control along with poor preventive practices against DF in the study participants. This observation revealed that health education intervention is necessary to enhance KAP regarding dengue prevention and vector control in Aligarh community.

Impact of dengue fever on depression, anxiety, and stress symptoms in Esmeraldas Province, Ecuador: a prospective cohort study

BackgroundPhysical symptoms of dengue have been documented extensively, but knowledge gaps on dengue-associated mental health hazards remain. We investigated the frequency of psychiatric symptoms (depression, anxiety, and stress) and neurocognitive performance during the first year after a dengue episode.MethodsUsing DASS-21 scores at 3, 6, and 12 months, we assessed depression, anxiety, and stress in anti-dengue IgM-positive adults and matched controls during the 2021 dengue season in Esmeraldas Province, Ecuador. Patients with DASS-21 scores ≤ 4 were considered normal; those with scores of 5–7, 8–10, and ≥ 11 indicated mild, moderate, and severe depression, respectively; cutoff scores for anxiety and stress were ≥ 5 and ≥ 9, respectively. We also assessed ‘delayed matching to sample’ (DMS) and ‘spatial working memory’ (SWM) using the Cambridge Neuropsychological Test Automated Battery.ResultsWe enrolled 102 cases and 78 controls. At 3 months, 90 cases and 70 controls were available for follow-up, among these 40/90 (44.4%) cases and 12/70 (17.1%) controls had DASS-21 scores ≥ 5 (RR 2.7, 95% CI [1.5–4.7]). Dengue remained a predictor for depression after adjusting for age, sex, and COVID-19 status. We observed no difference in anxiety between the groups, but stress scores increased at month 3 (RR 1.87, 95% CI [1.01–3.4]). DASS-21 scores normalized during follow-up. DMS and SWM did not differ between groups at 3 and 6 months. At month 12, cases had lower SWM than controls did (p value < 0.001).ConclusionsCare providers should be aware of dengue-associated mood disorders and facilitate timely referral to mental health services. Future longitudinal studies are warranted to validate our observations regarding the impact of dengue on mental health and neurocognitive status in affected patients.

Space-time dynamics of the dengue epidemic in Brazil, 2024: an insight for decision making

BackgroundDengue is a vector-borne viral infection caused by the dengue virus transmitted to humans primarily by Aedes aegypti. The year 2024 has been a historic year for dengue in Brazil, with the highest number of probable cases ever registered. Herein, we analyze the temporal trend and spatio-temporal dynamics of dengue cases in Brazil during the first nine epidemiological weeks (EW) of 2024.MethodsThis is an ecological study, including all probable cases of dengue in Brazil during the period, carried out in two steps: time series analysis to assess the temporal trend and spatial analysis to identify high-risk clusters.Results1,345,801 probable cases of dengue were reported. The regions with the highest increasing trend were the Northeast with an average epidemiologic week percent change (AEPC) of 52.4 (95% CI: 45.5–59.7; p < 0.001) and the South with 35.9 (95% CI: 27.7–44.5; p < 0.001). There was a statistically significant increasing trend in all states, except Acre (AEPC = -4.1; 95% CI: -16.3–10; p = 0.55), Amapá (AEPC = 1.3; 95% CI: -16.2–22.3; p = 0.9) and Espírito Santo (AEPC = 8.9; 95% CI: -15.7–40.6; p = 0.5). The retrospective space-time analysis showed a cluster within the Northeast, Central-West and Southeast regions, with a radius of 515.3 km, in which 1,267 municipalities and 525,324 of the cases were concentrated (RR = 6.3; p < 0.001). Regarding the spatial variation of the temporal trend, 21 risk areas were found, all of them located in Southeast or Central-West states. The area with the highest relative risk was Minas Gerais state, where 5,748 cases were concentrated (RR = 8.1; p < 0.001). Finally, a purely spatial analysis revealed 25 clusters, the one with the highest relative risk being composed of two municipalities in Acre (RR = 6.9; p < 0.001).ConclusionsWe described a detailed temporal-spatial analysis of dengue cases in the first EWs of 2024 in Brazil, which were mainly concentrated in the Southeast and Central-West regions. Overall, it is recommended that governments adopt public policies to control the the vector population in high-risk areas, as well as to prevent the spread of dengue fever to other areas of Brazil.

The ethanol extract of Sargassum duplicatum as an ovicidal agent against Aedes aegypti

Dengue hemorrhagic fever (DHF) is a major health concern in tropical and subtropical countries. Indonesia has DHF cases perennially every year. On the other hand, Indonesia is abundant with seaweed (Sargassum duplicatum), which can be found across its seashore. The macroalgae contains secondary metabolites with ovicidal activity; hence, it has the potential to be utilized in suppressing the Aedes aegypti. The aim of this study was to determine the ovicidal activity of S. duplicatum against the Ae. aegypti eggs. The algae were macerated with ethanol 70% before being subjected to qualitative phytochemical screenings. The ovicidal tests were conducted with an extract concentration of 50 ppm, 100 ppm, 500 ppm, 1000 ppm, and 1500 ppm, while distilled water was used as the control. The hatchability of Ae. aegypti was observed 24 hours a day for 4 days and the larval development was investigated under a microscope. Phytochemical screenings revealed that the extract was positive containing alkaloids, flavonoids, steroids, saponins, and phenols. The hatchability of Ae. aegypti eggs were significantly reduced following the S. duplicatum extract exposure for four days (p=0.000). The extract had LC50 of 828.653 ppm and LC50 of 1786.09 ppm for the ovicidal activity against Ae. aegypti eggs. The concentration of ethanol extract of S. duplicatum did not affect the mosquito development from larvae to adult stage (p=0.263). Further research is needed to explore the effect of specific compounds contained in the S. duplicatum and investigate their ovicidal potential.

Possible effects of ancestry-related oxysterol-binding protein-like 10 genetic polymorphisms on dengue virus replication and anti-dengue immune response

PurposeOxysterol-binding protein-like 10 (OSBPL10) gene has been associated with reduced susceptibility to severe dengue in individuals of African descent. The aim of this study was to determine the possible effect of OSBPL10 on dengue virus (DENV) replication as well as the impact of African and European haplotypes of six OSBPL10 small nuclear polymorphisms (SNPs) on dengue multiplication and innate immune response. MethodsWe conducted gene knockdown experiments targeting OSBPL10 in THP-1 and Huh-7D12 cell lines, followed by a DENV-2 replication assay. Extracellular viral load was determined using qRT-PCR. To investigate the impact of SNPs haplotypes on viral replication and gene expression we cultured peripheral blood mononuclear cells (PBMC) from individuals with homozygous African and European haplotypes of OSBPL10 with DENV-2. Individual genotyping was performed using High Resolution Melt (HRM) analysis. The level of viral replication was assessed through plaque assay, while RT-PCR was employed to determine the expression levels of RXR-α, IFN-γ, IL-10 and IL-8 genes. ResultsIn vitro OSBPL10 knockdown significantly reduced DENV-2 replication. Individuals carrying European haplotypes showed higher DENV titers along with elevated levels of RXR-α and IL-8 mRNA compared to those carrying African haplotypes, who exhibited lower viral loads alongside increased IFN-γ and IL-10 expression. ConclusionsOur findings further explore the role of OSBPL10 in DENV multiplication, immune response to infection. The European haplotypes of OSBPL10 appear to increase DENV replication and promote RXR-α and IL-8 mRNA expression which correlates with the suppressive effect of these mediators on type I IFN, promoting viral replication and a deficient antiviral response. In contrast, the African haplotype showed a reduction in DENV replication and enhanced IFN-γ and IL-10 mRNA expression, which could be related to the better management of dengue infection and the low frequency of severe disease in this ethnic groupe.

Dengue outbreaks in northern Nigeria: Evaluating the recommended Takeda vaccine and future prevention strategies.

Dengue fever, caused by the dengue virus (DENV), poses a significant public health challenge globally, with Nigeria experiencing sporadic outbreaks. A clear understanding of the dengue burden has not been achieved in Nigeria, just as in other African countries. Understanding the epidemiology and burden of dengue fever is essential for effective prevention and control strategies. This paper examines the recent dengue outbreaks in northern Nigeria, particularly in Sokoto state, and evaluates the recommended Takeda dengue vaccine (TDV) along with future prevention strategies. Despite limited surveillance and underreporting, dengue fever is endemic in Nigeria (with over 5 million cases and 5000 dengue-related deaths in 2023), with recent outbreaks indicating a growing concern. The TDV, a live attenuated tetravalent vaccine, has shown promise in preventing dengue fever, but challenges such as vaccine acceptance and accessibility need to be addressed. Global urbanization contributes to the disease's spread, which is influenced by factors such as population density, cultural beliefs, water storage practices, hygiene, and water supply accessibility. Future prevention strategies must focus on government intervention, community practices, and innovative vector control measures to mitigate the spread of DENV in Nigeria. This study will serve as a valuable reference for policymakers, researchers, and clinicians in the management and control of DENV in Nigeria and Africa as a whole.

Graphene-Based Nano Drug Delivery of Curcumin for the Treatment of Dengue Fever.

Graphene, which is defined as a single-layered sp2 hybridized carbon atoms placed in a honeycomb-like crystal lattice when converted to graphene oxide, has proven its worth by showing its tremendous capacity in controlling the release rate of drugs by entrapping in the numerous pockets present inside it through π-π stacking interaction when used as a nanocarrier. In this experiment graphene oxide was synthesized through traditional Hummer’s method and was used as a nanocarrier to target nanosized drugs, which was prepared by loading curcumin drug into the PVP functionalized graphene oxide by using necessary procedures. After the successful confirmation of the stability, functionalization, and compatibility through various characterization procedures and effective drug loading into the systems, the release behavior of the formulations has been checked through dialysis bag diffusion technique using potassium phosphate buffer saline (pH 7.2, 4.0 and 9.2) for selection of the best medium for determination of the successful sustained-release behavior of the drugs through the dialysis membrane which concluded with satisfactory, sustained and constant drug release phenomenon in the acidic environment reflecting an idea of the fact its favorable release in acidic pH. It is a fact known that dengue fever causes systemic acidosis i.e., reduction of the pH of blood below 7. Thus, when used in-vivo there is a possibility that the formulation has easy access to its target and, performs the desired mechanism of action and can be used as a therapeutic delivery system against the Dengue virus.

Dengue-Related Hemophagocytic Lymphohistiocytosis in an Adult: A Case Report and Brief Update

AbstractDengue virus is an arbovirus transmitted through the bite of infected Aedes mosquitoes. Many unusual clinical features are being reported in dengue. Dengue complicated with hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal condition. Here, we report an 18-year-old otherwise healthy female with dengue fever complicated with HLH. The diagnosis was made by fulfilling the clinical and laboratory criteria of HLH. She was managed successfully with a methylprednisolone pulse regimen. Our case highlights the importance of early recognition of complications and prompt treatment for a better outcome.

The Association Between Level of Education and Source of Information with Community’s Optimal Prevention Measures Against Dengue Haemorrhagic Fever: A Cross-Sectional Study in The Coastal Area of Suli Village, Maluku, Indonesia

Objective: This study aimed to examine the relationship between sociodemographic factors and sources of information about dengue haemorrhagic fever (DHF) and the level of DHF prevention measures in the coastal community of Suli Village, Maluku Province, Indonesia.Material and Methods: The data were derived from a survey conducted in December 2022 involving 217 participants living in the coastal area of Suli Village, Central Maluku District. The dependent variable was the level of DHF prevention measures (i.e., high if the score was 8 to 10 points and low if the score was 7 points or lower). The independent variables included respondents’ age, sex, occupation, education level, household income, and sources of information about DHF. Logistic regression analyses were performed to examine the associations between sociodemographic factors and sources of information about DHF and levels of DHF prevention measures.Results: Only 31% of the respondents had high DHF prevention measures. The odds of having a high level of DHF prevention measures were lower in respondents with junior/senior high school education (adjusted odds ratio (aOR)=0.23; 95% confidence interval [CI]: 0.09–0.57; p-value=0.002). The odds were also lower in respondents who received information about DHF from family/friends/neighbours compared to those who received the information from health workers (aOR=0.22; 95% CI: 0.07–0.71; p-value=0.011).Conclusion: Health workers play an important role as health educators. Future studies should consider using both qualitative and qualitative methods to explore motivations, beliefs, and various contextual factors that influence DHF prevention measures in a community.

Genome sequence of dengue virus serotype 1 isolated from a pediatric patient enrolled in an Ivermectin trial in Thailand.

We sequenced the genome of dengue virus serotype 1 (DENV1) strain 4101301, isolated from a child with dengue fever in Thailand and cultured in C6/36 mosquito cells. These data are crucial for studying DENV1's genetic diversity, evolution, and epidemiology and advancing the knowledge for developing antiviral drugs and vaccines targeting DENV.

Exploring variations in dengue symptoms: a comparative study of 2013, 2019, and 2023 in a tertiary care hospital of Bangladesh

Background: Dengue fever remains a major public health issue in Bangladesh, with repeated outbreaks. This study compares dengue symptoms in a tertiary care hospital during 2013, 2019, and 2023. The purpose of this study is to evaluate the variations in dengue symptoms among Bangladeshi dengue patients from 2013 and 2019 to 2023. Methods: This was a cross-sectional study, conducted on 100 dengue positive patients, admitted between 1st January to 7th August 2023, to the Medicine Department, Holy Family Red Crescent Medical College and Hospital, Dhaka. Demographic data, sign and symptoms and laboratory investigation reports were collected. These data were compared with a previously published study from the same institute comparing dengue symptoms between 2013 and 2019 among admitted dengue patients. The study employed a convenience sampling method for participant selection, and data analysis was carried out using SPSS version 26. Results: Analysis of 100 sero-positive dengue cases reveals a predominant occurrence in the 20 to 40 age group (51%), with the mean age of patients being 34.5 years. Among these cases, a higher prevalence is observed in males (62%) compared to females (38%). Symptomatology exhibits variations over time, with fever being consistently present. Other symptoms such as headache (90%, 23% and 12%), retroorbital pain (45%, 3% and 16%), skin rash (16%, 4% and 1%) and constipation (32%, 1% and 5%) showing fluctuations, respectively in 2013, 2019 and 2023. Notably, a significant proportion of patients in 2023 exhibit normal ultrasound findings (53%). Conclusions: In conclusion, our study provides a comprehensive analysis of Dengue infection dynamics over a decade, highlighting significant variations in clinical manifestations, laboratory findings, and abdominal ultrasound results among Bangladeshi patients. The findings suggest that Dengue remains a considerable public health concern, with fluctuations observed in symptomatology, including fever and other associated symptoms, and changes in laboratory parameters over time. BIRDEM Med J 2024; 14(3): 131-136

Larvicidal Activity of Zingiber purpureum Roscoe Essential Oil from East Kalimantan in Preventing Dengue Hemorrhagic Fever

Temephos is extensively employed currently to eliminate Aedes aegypti mosquito larvae, thus preventing the spread of dengue fever. Raising the level of temephos application can lead to health issues for individuals and long-term detrimental impacts on the environment. This research aims to demonstrate that Z. purpureum Rosc. essential oil effective in eliminating more than 70% of Aedes aegypti mosquito larvae. Z. purpureum Rosc.essential oil was diluted with Tween 80 to achieve various concentrations, namely 12.5 μg/mL, 25 μg/mL, 50 μg/mL, and 100 μg/mL. A positive control was established using temephos at a concentration of 0.012 mg/L, while a negative control was prepared using clean water. The larvae were subjected to these treatments for a duration of 48 hours, with three repetitions conducted. The data were analyzed using the Kruskal Wallis Test that shows a significant difference between treatment groups, with a p value &lt;0.05. A concentration of 12.5 μg/mL of Z. purpureum Rosc. essential oil was found to effectively eliminate 76.67% of Aedes aegypti mosquito larvae. A concentration of 25 μg/mL of Z. purpureum Rosc. essential oil was found to effectively eliminate 86.67% of Aedes aegypti mosquito larvae. A concentration of 50 μg/mL of Z. purpureum Rosc. essential oil was found to effectively eliminate 96.67% of Aedes aegypti mosquito larvae. A concentration of 100 μg/mL of Z. purpureum Rosc. essential oil was found to effectively eliminate 100% of Aedes aegypti mosquito larvae. The overall findings show that more than 70% of Aedes aegypti mosquito larvae are effectively killed by Z. purpureum Rosc. essential oil at a concentration of 12.5 μg/mL.

ĐẶC ĐIỂM DỊCH TỄ LÂM SÀNG, CẬN LÂM SÀNG BỆNH SỐT XUẤT HUYẾT DENGUE Ở TRẺ EM TẠI BỆNH VIỆN SẢN NHI NGHỆ AN

Dengue hemorrhagic fever is rising in many localities nationwide, including Nghe An. The movement of people carrying the Dengue virus increases the risk of an outbreak. The study aimed to describe dengue's epidemiological, clinical and paraclinical characteristics in children. The results show that children living in rural areas have a higher infection rate than those in urban areas; the disease frequency is mainly in the rainy season from August to December. There are 50% of children hospitalized in the early stages of the disease. The danger of the disease is that common clinical symptoms are joint pain and muscle fatigue; tired, abdominal pain in the liver area, and enlarged liver; Hemorrhagic manifestations, of which subcutaneous bleeding is the most common; 4.7% had symptoms of shock due to dengue fever; 31.3% had a platelet count reduced below 50.109/l. Subclinical liver enzymes (GOT, GPT) increased mainly at mild and moderate levels. Dengue IgM and Dengue NS1Ag tests appeared in 3 stages of the disease; Dengue IgG only appeared in the later stages, in which the recovery phase accounts for the highest rate. Dengue hemorrhagic fever can have clinical manifestations ranging from mild to severe, with complications of hypovolemic shock that can potentially lead to cardiovascular collapse, severe organ failure shock or severe bleeding. If not detected and treated promptly, it can lead to death, especially in children. Keywords: Dengue hemorrhagic fever; children; Nghe An Obstetrics and Pediatrics Hospital.

Differential Classification of Dengue, Zika, and Chikungunya Using Machine Learning—Random Forest and Decision Tree Techniques

Differential Classification of Dengue, Zika, and Chikungunya Using Machine Learning—Random Forest and Decision Tree Techniques

Vaccination against dengue fever for travellers.

Dengue fever, endemic to most tropical and subtropical countries, is a major cause of illness in travellers, but severe dengue, hospitalisation and death are considered rare in this population. Two vaccines against dengue fever, Dengvaxia®and Qdenga®, are available. While there is no recommendation for the use of Dengvaxia®in travellers, Qdenga®has been licensed for travellers in many European countries since December 2022, most recently (29 July 2024) in Switzerland by Swissmedic. The Swiss Expert Committee for Travel Medicine (ECTM), having assessed available data on the Qdenga®vaccine, issues the following recommendations: (1) Vaccination against dengue fever virus with Qdenga®is not recommended for persons with no previous dengue fever infection. (2) Vaccination with Qdenga®may be recommended for travellers aged 6 years and older who have evidence of previous dengue infection, defined as (a) a laboratory-confirmed dengue infection (PCR, antigen or seroconversion)or(b) a compatible history of dengue infection with a positive IgG serological test AND expected exposure to a region with significant dengue transmission. Travel medicine advisors should provide clear information in accessible language on the complexity of dengue vaccines and the risk/benefit evaluation for their use in travellers.

Dengue fever as autochthonous infectious disease in Italy: Epidemiological, clinical and virological characteristics

BackgroundSince August to November 2023, 82 cases of autochthonous or non-travel related Dengue virus (DENV) infection have been reported in Italy, highlighting a concerning trend of local transmission. We describe the clinical and laboratory findings of 10 autochthonous DENV in the metropolitan area of Rome admitted to the Lazzaro Spallanzani National Institute for Infectious Diseases. Method and resultsTen patients (3 males, 7 females; median age: 51) with classic dengue fever symptoms were admitted between August and November 2023. Laboratory tests confirmed dengue infection through DENV non-structural protein 1 and/or immunoglobulins (IgM/IgG) positive tests, moreover leukopenia, thrombocytopenia, elevated transaminases were detected. A subset of patients underwent extensive biological sampling, including real-time RT-PCR and immunofluorescence, to monitor DENV-RNA and antibody levels over 30 days. DENV-1 was detected in 8 patients and DENV-3 in 2. Upon admission specific IgM antibodies were found in 7 patients while IgG antibodies in 4 patients. DENV RNA was consistently detected in blood within the first 8 days but was less common in saliva and urine. No DENV RNA was detected after day 24. ConclusionThese findings contribute to the understanding of the clinical course of DENV infection in a non-endemic setting as integrated epidemiological and clinical model to increase syndromic surveillance and timely diagnosis of DENV infections.

Analyzing and Forecasting Dengue Fever Incidence in Thailand: A Comprehensive Study for Public Health Preparedness

Analyzing and Forecasting Dengue Fever Incidence in Thailand: A Comprehensive Study for Public Health Preparedness

Diagnostics for detection and surveillance of priority epidemic-prone diseases in Africa: an assessment of testing capacity and laboratory strengthening needs.

In 2023, Africa experienced 180 public health emergencies, of which 90% were infectious diseases and 75% were related to zoonotic diseases. Testing capacity for epidemic-prone diseases is essential to enable rapid and accurate identification of causative agents, and for action to prevent disease spread. Moreover, testing is pivotal in monitoring disease transmission, evaluating public health interventions and informing targeted resource allocation during outbreaks. An online, self-assessment survey was conducted in African Union Member States to identify major challenges in testing for epidemic-prone diseases. The survey assessed current capacity for diagnosing priority epidemic-prone diseases at different laboratory levels. It explored challenges in establishing and maintaining testing capacity to improve outbreak response and mitigate public health impact. Survey data analysed diagnostic capacity for priority infectious diseases, diagnostic technologies in use, existing surveillance programmes and challenges limiting diagnostic capacity, by country. The survey result from 15 Member States who responded to the survey, showed high variability in testing capacity and technologies across countries and diverse factors limiting testing capacity for certain priority diseases like dengue and Crimean-Congo haemorrhagic fever. At the same time diagnostic capacity is better for coronavirus disease 2019 (COVID-19), polio, and measles due to previous investments. Unfortunately, many countries are not utilizing multiplex testing, despite its potential to improve diagnostic access. The challenges of limited laboratory capacity for testing future outbreaks are indeed significant. Recent disease outbreaks in Africa have underscored the urgent need to strengthen diagnostic capacity and introduce cost-effective technologies. Small sample sizes and differing disease prioritisation within each country limited the analysis. These findings suggest the benefits of evaluating laboratory testing capacity for epidemic-prone diseases and highlight the importance of effectively addressing challenges to detect diseases and prevent future pandemics.

Health Literacy in Preventing and Controlling Dengue Hemorrhagic Fever Among Village Health Volunteer, Pattani Province, Thailand

Background: Dengue Haemorrhagic Fever (DHF) is a mosquito-borne viral infection caused by the dengue virus (DENV). The situation of the DHF prevalence rate was still high in the community. One reason for this high rate involves community members, who had less participated in the prevention and control measures of DHF. Objectives: This descriptive study aimed to study factors associated with preventing and controlling DHF among village health volunteer, Pattani Province. Methods: Population consisted of 6,841 village health volunteers registered in Pattani Province, Thailand, in fiscal year 2020, and the sample size was calculated using Daniel formula for 215 cases, and systematic random sampling was carried out for collecting data. Data were collected by questionnaires composed of 3 parts, including characteristics, health literacy factors, and preventing and controlling DHF. In addition to check questionnaire standardization, validity was checked by three experts and try out testing reliability by Cronbach’s coefficient alpha about 0.87. Data were analysed using statistical as Pearson product moment correlation coefficient and Stepwise Multiple Regression Analysis. Results: The analysis found that health literacy factors were associated with preventing and controlling DHF among village health volunteer, Pattani Province such as access skill (r=0.310, p-value&lt;0.001) communication skill (r=0.201, p-value=0.003) media literacy skill (r=0.386, p-value&lt;0.001) decision skill (r=0.349, p-value&lt;0.001) self-management skill (r=0.480, p-value&lt;0.001), respectively. Conversely, cognitive skill had no association (r=0.117, p-value=0.086). Conclusion: The finding showed that health literacy of village health volunteer was associated with the preventing and controlling DHF. Therefore, health workers should encourage the village health volunteers to participate in sustainable prevention and control of DHF.

The Relationship Between Knowledge and Community Behavior In Efforts to Prevent Dengue Hemorrhagic Fever In The Sogaten Village Area, Manguharjo District, Madiun City In 2024

The Relationship Between Knowledge and Community Behavior In Efforts to Prevent Dengue Hemorrhagic Fever In The Sogaten Village Area, Manguharjo District, Madiun City In 2024