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Indian Journal of Community Medicine

Community Perception Regarding Mosquito-Borne Diseases with Special Reference to Dengue

Author(s): K. Ravi Kumar, G. Gururaj

Vol. 30, No. 4 (2005-10 - 2005-12)

Introduction:

The WHO guide for diagnosis, treatment and control of dengue haemorrhagic fever1, has mentioned that source reduction is potentially the ideal method for controlling A. aegypti. Source reduction is the method applied to prevent breeding of mosquito by taking care of the larval breeding sources. It requires public motivation through health education and usually legislation and law enforcement to encourage community participation2. Similarly in the control of other vector borne diseases community participation is vital. To develop a suitable health education strategy it is necessary to understand the level of knowledge and perceived risk of the community regarding mosquito-borne infectious diseases to determine what practices the people use to prevent mosquito bites at home, to determine media type and specific channels of communication for effective and efficient dissemination of information.

Materials and Methods:

The study was conducted in an urban locality in Bangalore city and a rural locality in a selected district. The study was conducted by interview technique using an open ended questionnaire. The information gathered focused upon the perceptions of people on mosquitoes, the diseases spread by them, the preventive actions that can be undertaken, Multistage sampling method was used to select district/PHC/ Subcenter /village. In the urban area, one Urban Family Welfare Centers (UFWC) was selected at random by lottery among all the UFWCs existing. Systematic sampling was done at the village / UFWC level by selecting every tenth house to select at least 10% of the houses. The results were analyzed using the EPI-INFO software.

Results and Discussion:

In the urban sample, more than half the houses had television. Only about 23% of the households had newspaper. About 19% of the houses had television and newspaper. Only about 14% of the houses had radio. In the rural sample, about 53% of the rural respondents did not have any media aids at home. About 35% had television at home. About 15% had radio. Only a small 4% of people interviewed had newspaper at home.

About 93.5% of the respondents in the urban sample perceived mosquitoes as a problem. When these were further queried as to why they perceive mosquitoes as a problem, about 80% of them mentioned that it is because they bite and this causes nuisance. In the rural sample too, even greater number mentioned biting. Only about 15% mentioned about disease.

In the urban sample about 20% could not say anything about this. About 76% mentioned that mainly they experience mosquito bites at night. About 3.5% of them mentioned about daytime. In the rural area about 95% people mentioned that they get bitten mostly at night.

In the urban sample 28% of the interviewees did not know where the mosquito breeds. About 8% of the respondents mentioned garbage or green plants. It was also noticed that almost all the other respondents associated drains or stagnant water with mosquito breeding. Only a very small percentage of people associated clean water collections with mosquito breeding. In the rural sample, an even larger number of 38% did not know where the mosquitoes breed. About 32% mentioned drains. About 13% mentioned other stagnant water. Incorrect answer of green plants/garbage/cowshed/cow dung was given by a lesser number of 5%. Hardly anybody associated mosquito breeding with cleaner water. All the correct answers were clubbed and a comparison.

When asked what preventive measures they can take against mosquitoes, about 34% mentioned that they were not aware of any measure. About 30% mentioned that surroundings should be kept clean. 12% people mentioned that proper drainage is the measure. In the rural sample, about 43% were not aware of any method. About one fourth mentioned that proper drainage is necessary. 12% mentioned about keeping the surroundings clean and about 11% mentioned about spraying chemicals on water.

The people were asked whether they were aware that Government is taking some measure. Only about 25% in the urban sample mentioned that they were aware. About 41% were not knowing about it. About 35% mentioned that Government is not doing anything. This shows that people were hardly aware of the governmental efforts. So the question of the active participation of the community remains to be answered.

In the rural sample, about 19% mentioned that drains are being cleaned. About 15% mentioned that chemicals are being sprayed on water. About 6% of people mentioned about cleaning of garbage. In the rural sample, there were 283 people who mentioned that Government is doing something. These were queried further regarding details. About 57% mentioned that drains are being cleaned. 38% mentioned that chemicals (insecticides) are being sprayed in the houses on the walls.

The perception of these people about the work of the governmental efforts was measured by asking whether they think what the government is doing is enough. About 10% of these could not respond in any way. Only 15% of them mentioned that the work is enough. The rest felt that what the government is doing is not enough. As far as the rural sample is concerned, a larger number of 39.6% could not comment. Only 12% of them mentioned that the work is enough. The rest 48% felt that what the government is doing is not enough.

In the urban sample, a considerable number of about 27% of those interviewed were using mosquito coils and about 17% were using mosquito mats. About 15% of people told that they were using fans. About 4% mentioned about coverning themselves with blankets/bed sheets. Only 3% were using bednets. About 11% were using combinations of above. About 22% of people mentioned that they were not doing anything. In the rural sample the largest number i.e. 22.6% mentioned that they would cover themselves with blanket while sleeping. About 16.3% of those interviewed were using mosquito coils and about 3.3% were using mosquito mats. Fourteen per cent were using bednets. Some (7.8%) mentioned that they were applying smoke. A few mentioned these things, in combination. About 16.2% of people mentioned that they were not doing anything.

A large percentage of about 51% mentioned malaria. About 44% of people were not aware of any disease being transmitted. About 3.6% of people mentioned other diseases. Only a very few people mentioned about Filariasis, Dengue or Japanese encephalitis. In the rural people sample about 59% of people were not aware of any disease being transmitted. A considerable percentage of about 34.3% mentioned malaria.

In the urban sample about 35% of them were not aware of an About 31% mentioned fever. About 18% mentioned fever and body ache. Other people mentioned symptoms like nausea/ vomiting, shivering, and combinations of these. In the rural sample, 31% were not aware of any symptoms. About 22% mentioned fever and shivering. About 21% were aware of fever as the main symptom. About 16% mentioned fever and body ache. About 12.5% mentioned fever, body ache and shivering.

The people were asked as to the source of their information. About 27% mentioned observation/experience. About 17% mentioned about neighbours. Similar numbers mentioned about learning about it in schools/colleges. About 9.5% of people mentioned television. Only about 5% people mentioned doctors/health workers.

In the rural sample we could see that neighbours constitute the largest source of information (22%). About 18.2% mentioned observation/experience. About 15.5% mentioned learning about it in schools/colleges. Only about 6.6% people mentioned doctors/health workers. 35% of people were not specific. Nobody mentioned about television. Only 0.2% mentioned radio.

In the urban sample, there were 347 fever cases. They were further asked about the action taken for treatment. In the urban sample, about 67% consulted the private medical practitioner. About 25% did self medication like buying medicines across the counter. Only 2% went to the governmental general hospital. In the rural sample, there were 265 cases of fever. The action taken indicated that 33% went to the private practitioner. About 26% approached the health workers. About 18% did self medication like home remedies or buying some tablets. About 8% went to the general hospital. The health education strategies should concentrate on the disease causing potential of the mosquitoes; daytime biting nature of Aedes mosquitoes; the breeding of Anopheles and Aedes mosquitoes in relatively cleaner water in domestic water containers.

References:

  1. WHO guide for diagnosis, treatment and control of DHF. Report of WHO tech. Adv. Committee on DHF, 1980.
  2. WHO, Community participation in the prevention and control of DF/DHF. Report of a meeting of the WHO scientific working group, Bangkok, Thailand, 13-17 December 1983. SEA/ Haem. Fever/46, 1984.

Dr. K. Ravi Kumar, 1049, 14th Main Srinagar, Bangalore 560050, India.

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