I.D.

Number: __________________________

SURVEY QUESTIONNAIRE
Awareness level and preventative practices of Mosquito borne infections in Urban Slums of Karachi.

Part A: Participant Demographics

A1 Gender of participant 1. Male

2. Female

A2 Age (in years) of participant 1. 16-18

2. 18-30
3. 30-50
4. >50
Specify in years________________________

A3 Location of residence 1. Urban

2. Semi-urban
A4 Educational Level of participant 1. No Formal Education
2. Primary
3. Middle
4. Secondary
5. Intermediate
6. Graduate
7. Post Graduate

A5 Occupation of participant 1. House wife

2. Unemployed
Employed (if yes, please specify occupation below)
_______________________________

A6 History of Malarial Fever in last six 1. Yes

months? 2. No
99. Don’t know

A7 History of dengue Fever in last six 1. Yes

months? 2. No
99. Don’t know

A8 History of chikungunya Fever in last six 1. Yes

months? 2. No
99. Don’t know

Part B: Knowledge of mosquito borne infection

B1 Have you heard about Malaria? 1.Yes

2.No
99. Don’t know

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I.D. Number: __________________________

B2 What are the most important 1.High fever and chills

symptoms of malaria? 2.Headache, & fatigue
3.Nausea & vomiting
4. Joint pain
5. Abdominal pain
98. Don’t know
99.Other (specify) ____________________________

B3 What is the mode of transmission for 1.Anopheles mosquito bites

malaria? 2.Aedes mosquito bites
3.Related to Climatic condition
4.Related to eating contaminated food
5.Related to swimming in rivers and ponds
99.Other (specify) ___________________

B4 What is the breeding place of malaria 1.Standing water/pools

mosquito? 2.Stored water
3.Plants
4.Garbage/gutter
5.Drains
6.Soil
7.I do not know
8.Small streams
99.Other (specify) ____________________________

B5 Have you heard about Dengue? 1.Yes

2.No
99. Don’t know

B6 What are the most important 1. Mild Fever

symptoms of dengue? 2.Headache, Eye & Joint pain
3.Rashes on arms and face
4.Bleeding from nose or gums
5.Shivering
6.Nausea and vomiting
98. Don’t know
99.Other (specify) ____________________________

B7 What is the mode of transmission for 1.Anopheles mosquito bites

dengue? 2.Aedes mosquito bites
3.Related to Climatic condition
4.Related to eating contaminated food
5.Related to swimming in rivers and ponds
B8 What is the breeding place of dengue 1.Stagnant water
mosquito? 2.Clean stored water
3.Indoor Plants

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I.D. Number: __________________________

4.Garbage/gutter
5.Drains
6.Soil
7.I do not know
99.Other (specify) ____________________________

B9 Have you heard about Chikungunya? 1.Yes

2.No
99. Don’t know

B10 What are the most important 1.Fever

symptoms of Chikungunya?
2.Headache, Joint & muscle pain
3.Rashes on arms and abdomen
4.Nausea and vomiting
5.Lower body disability
6.Swelling around joints
98. Don’t know
99.Other (specify) ____________________________

B11 What is the mode of transmission for 1.Anopheles mosquito bites

chikungunya? 2.Aedes mosquito bites
3.Related to Climatic condition
4.Related to eating contaminated food
5.Related to swimming in rivers and ponds
99.Other (specify) ____________________________
____________________________

B12 What is the breeding place of 1. Stagnant water

chikungunya mosquito? 2.Clean stored water
3.Indoor Plants
4.Garbage/gutter
5.Drains
6.Soil
7.I do not know
99.Other (specify) ____________________________

B13 In which season mosquito borne 1.Rainy

infections are more common? 2.Dry
3.there is no difference
4.I do not know
99.Other (specify) ____________________________

B14 In what month (s) of the year are 1.Summer

mosquito borne infections prevalent? 2.Winter
3.Spring
4.Autumn

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I.D. Number: __________________________

5.I do not know

99.Other (specify) ____________________________

B15 What is your source of information 1.Radio and TV

about mosquito borne infections?
2.Newspaper
3.Teachers and schools
4.By community health workers
5.By other people
99.Other (specify) ____________________________

B16 Have you seen cases suffering with 1.Yes

these infections in your neighborhood, 2.No
family or relatives? 98. Don’t know

B17 Do you have enough health facility in 1.Yes

your area for diagnosis and treatment 2.No
of such cases? 98. Don’t know

B18 What types of facilities are available 1.Government hospital

there? 2.Private clinic
3.Health center
99.Others (specify) __________________

Part C: Attitudes and practices of participants regarding mosquito borne infections

C1 Do you think mosquito borne 1.Yes

infections are a preventable? 2.No
98. Don’t know

C2 How can these infections be 1.Removing drains, water pods

prevented? (if yes in above question) 2.Removing garbage
3.Mosquitoes sprays
Specify ____________________________

C3 Where do you rest in summer nights? 1.Room

2.Porch
3.Yard
4.Roof top
99.Other (specify) ____________________________

C4 What do you refer for mosquito borne 1.Self-medication

infections treatment? 2.Government medical services
3.Private medical services
4.Home remedy
99.Others (specify) ____________

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I.D. Number: __________________________

C5 Do you store water inside home (In 1.Yes

tanks etc.)? 2.No
98. Don’t know

C6 Are these water storage tanks covered 1.Yes

with lid? 2.No
98. Don’t know
C7 Is there standing water in your 1.Yes
neighborhood? 2.No
98. Don’t know

C8 Are there open drainage pipes / 1.Yes

sewerage lines in your area or 2.No
neighborhood? 98. Don’t know

C9 Any effort is done to remove stagnant 1.Yes

water or to fix open sewerage system 2.No
in your neighborhood? 98. Don’t know

C10 If yes, then by whom? 1.Govt. officials

2.People help themselves
3.Area maintenance committee
4.Any NGO
99.Others (specify) _______________

Part D: Preventative measures regarding mosquito borne infections

D1 Do you use bed net during sleeping (at 1.Yes

night)? 2.No
98. Don’t know

D2 Do you use any mosquito repellent or 1.Yes

Ointment? 2.No
98. Don’t know

D3 Do you use any insecticide/s (sprays, 1.Yes

powder etc.) to kill mosquitoes? 2.No
98. Don’t know

D5 Do you know about mosquito 1.Yes

repellent properties of plants? 2.No
98.Don’t know

D6 Do you clean drains and surroundings? 1.Yes

2.No
D7 If yes specify name ___________ Naz-boo
Neem,

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I.D. Number: __________________________

Marigold (Gainda)
Garlic plants?
99.Other (specify) ____________________________

D8 What are your non drinking-stored 1.Covered

water practices? 2.Use chemical
3.Changing water frequently

D8 In your opinion, what efforts should

be done to reduce incidence of these
(Malaria, Dengue & Chikungunya)
mosquito borne illness?