Indian Journal of Community Medicine Vol. 31, No.

3, July-September, 2006

Knowledge, Attitude & Practice (KAP) on Dengue fever: A Hospital Based Study
S Matta, S Bhalla, D Singh, S K Rasania, S Singh

Introduction Dengue/Dengue Hemorrhagic Fever (DHF) is an emergent disease in India. It is endemic in some parts of country and contributes annual outbreaks of dengue/ DHF1. Dengue virus infection is endemic in and around Delhi with peak incidence between September and November2. In the year 2003, (from 1 June to 9 November), 2185 laboratory confirmed cases of dengue fever had been reported in Delhi and surrounding areas3. The present KAP study was done with the aim of assessing knowledge regarding Dengue fever among general population attending a hospital out patient department. Another aim was to assess, whether simple preventive measures to check and destroy the breeding sites of mosquito like checking of coolers, discarded tires, flower pots etc. are being practiced in the community. Material & Methods This study was done in, the OPD of Safdarjang Hospital, New Delhi. Every second patient coming out of general OPD was interviewed with a pre-designed questionnaire. Apart from education & occupation of the respondents, questions on knowledge about Dengue fever, its signs & symptoms & preventive practices like checking of coolers, tires etc for mosquito breeding were included in the questionnaire. Overall 500 interviews were taken in 28 days (from 1st October to 28th October 2003). Interviews were taken by Senior residents of Community Medicine Department, VMMC & Safdarjang hospital, New Delhi. Results were compiled & analyzed on windows 98 (MS word/Excel) version. Results & Discussion Overall 338 males and 162 females were interviewed. Study population largely comprised of adults and literate individuals (Table I) as out of 500 persons surveyed, 432 (84.6 %) were from the age group of 26 - 40 years. 449 (89.8 %) were literates. Overall 82.4 percent respondents knew that dengue fever is transmitted by mosquito & 54 persons associated Dengue with flies/person to person transmission. A field-based study from Thailand4 also had similar findings. Another study from Delhi5 concluded that 71 and 89 percent respondents from rural and urban areas respectively had the knowledge regarding mosquito transmission. Regarding knowledge about signs and symptoms of dengue, 309 (61.8 %) persons could enumerate one symptom (fever), 103(20.6%) persons
Deptt. of Community Medicine, VMMC & Safdarjang Hospital, New Delhi. Email : shankermatta@yahoo.com Recieved : 5.02.05
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Table I : Education & Occupation of Respondents (N=500) Education Illiterate Higher secondary Senior secondary No. 45 47 117 % 9.0 9.4 23.4 Occupation Daily wager housewife No. 49 86 % 9.8 17.2 23.8 43.2 6.0

Computer /Call 119 center operator Government official *Miscellaneous 216 30

Post graduate No comments

287 4

57.4 0.8

*truck driver, tailor, car mechanic etc.

could enumerate 2 symptoms (fever, bleeding) and 56(11.2%) persons could enumerate 3 symptoms of Dengue (fever, headache & bleeding). Similar findings were also reported by another study5. Regarding knowledge about breeding, 399 (79.8 %) respondents knew about breeding places of mosquitoes. Coolers as the most probable breeding site (for mosquitoes) was named by 42.4 percent respondents followed by cooler & tires by 24.2 percent (Table II). It has already been substantiated4,5,6 that people have good idea about the breeding places of mosquitoes. 326 (65.2) respondents were having redundant tires, plastic pots and flower pots on rooftops or in their houses, & they accepted the fact, that they were never checking them for mosquito breeding. Out of 178 (35.6 %) persons having cooler in their house, 98 (55.0 %) said that they never check coolers for mosquito breeding. Only 42 (23.5 %) persons were correctly checking the cooler on weekly basis. It may be concluded that though the knowledge regarding dengue is good in the general population, practice of checking coolers, tires & flower pots is quite poor. Similar findings were reported by another study7. On the contrary, a study from Kuala Kangsar6 concludes a significant association between knowledge of dengue and attitude towards Aides control.
Table II : Knowledge Regarding Breeding Places of Mosquitoes Options Coolers Coolers & Tires Coolers, Tires & flower Burrows & pits Vessels/ Containers Coconut shells No comments/not aware No. (N=500) 212 121 30 16 11 9 101 % 42.4 24.2 7.6 pots 3.2 3.8 1.8 20.2 KAP on Dengue Fever

Indian Journal of Community Medicine Vol. 31, No. 3, July-September, 2006

As far as various preventive measures to check the breeding are concerned, a total of 74 respondents said that they check the coolers. They included 31 (41.0%) who changed the water, 12 (16.2%) who cleaned the coolers thoroughly and 32 (43.2 %) who added Kerosene oil. Regarding personal protection against mosquito bite 386 (77.2 %) respondents were relying upon Mats/coils and 101 (20.2 %) were using bed nets.l3 respondents did not give any comments. Regarding the source of information on Dengue fever, out of 500 respondents, 286 (57.2%) came to know about Dengue fever through television and/or radio followed, by 24.2%, to newspapers and banners. This is in agreement with other studies 1. 93 (19.0 %) respondents did not give any comments. Role of IEC and of mass media for delivering the IEC has been highlighted elsewhere6. The fact that this disease is endemic in and around Delhi with its peak incidence between September and November 2 highlights the need for proper monitoring and surveillance of Dengue infection right from the time when the transmission season is about to start. Strengthening of surveillance along with health education to the community and proper training of health personnel can go long way in control of Dengue infection1.
References 1. Sharma SN, Raina VK, Kumar A. Dengue/DHF: An emerging disease in India. J Com. Dis. 2000; 32(3):175-9.

2.

Kurukumbi M, Wali JP, Broor S, Aggarwal P, Seth P, Handa R, Dhar L, Vajapayee M. Seroepidemiology and active surveillance of dengue fever/dengue haemorrhagic fever in Delhi. Indian J Med Sci. 2001; 55(3): 149-56. World health report, Communicable Disease Surveillance & Response (CSR), Dengue fever in India - update, 12 November, 2003 Web site: (http://www.who.int/csr/ don/2003_11_12/en/). Swaddiwudhipong W, Lerdlukanavonge P, Khumklam P, Koonchote S, Nguntra P, Chaovakiratipong C. A survey of knowledge, attitude and practice of the prevention of dengue hemorrhagic fever in an urban community of Thailand. Southeast Asian J Trop Med Public Health. 1992; 23(2):207-11. Gupta P, Kumar P, Aggarwal OP., Knowledge, attitude and practices related to dengue in rural and slum areas of Delhi after the dengue epidemic of 1996. J Commun Dis. 1998 Jun; 30(2): 107 -12. Hairi F, Ong CH, Suhaimi A, Tsung TW, bin Anis Ahmad MA, Sundaraj C, Soe MM. Knowledge, attitude and practices (KAP) study on dengue among selected Rural communities in the Kuala Kangsar district. Asia Pacific J Public Health. 2003; 15(1) : 37-43. Degallier N, Vilarinhos PT, de Carvalho MS, Knox MB, Caetano J Jr Peoples Knowledge and practice about dengue, its vectors, and control means in Brasilia (DF), Brazil: its relevance with entomological factors. J Am Mosq Control Assoc. 2000;16(2):114-23.

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Book Review
Essentials of Management- fifth edition by Prof. Harold Koontz and Prof. Heinz Weihrich 530 pp,published by Tata McCrraw Hill Publishing Company Limited, 7 West Patel Nagar, New Delhi. Dr Koontz and Dr. Weihrich deserve to be congratulated and praised for writing this concise book on management. Part-1 covers the basis of management science, its theory and practices and also includes the system model which serves as the framework of this group. Part 2 through 6 discusses the management functions of planning, organizing, staffing, leading and controlling. Part-7 focuses on challenges in international environment. Some new topics like model for ethical decision making, interpreneurship and entrepreneurship, organizational culture, newer challenges in information technology have also been added in this edition. Throughout the book, cases, real life situations, international perspectives, exercises have been added to illustrate managerial concepts and theories. Figures and tables have also been included for clear depiction of concepts. My overall comments about the book is that it is very nicely written, comprehensive and will be of great help to all the doctors who want to be more effective in managerial skills and aspire for managerial roles in the future. Dr. Sonu Goel,

Deptt. of Community Medicine, PGIMER, Chandigarh Received : 28.10.05

KAP on Dengue Fever 186