Original Article Knowledge and Awareness of Dengue in Students of CMH Medical and Dental College, Lahore Zoofishan Imran, Hafiza Hira Zeb, Malik Sabor Nasser ABSTRACT. ‘Objective: Wesimed o assess knowledge of medical students about dengue, its spread and prevention, Study design: Cross sectional study Place of Stady: CMH Lahore Medical College, Lahore Methodology:Self administered questionnaires were randomly distributed among 200 students between 18-25 years of ge from frst to fifth year MBBS, Results: The result of our study showed that there was good level ofknowledge about dengue its vector transmission and protectionamong the sludents [twas also seen tha! the knowledge of causative agent and mode of spread was almost equal among studens from Lat year MBBS to-th year MBBS. However, knowledge about is treatment and prevention was more among 3rd year and 4th year students duc to their advanced knowledge through books. Students are using personal protective measures for engue which s the basi sep ints prevention ‘Conclusion: Our cross sectional study has shown in general a very good level of awareness about dengue fever among medical students of (CMH Lahore Medical College. KeyWords: Dengue, Knowledge, Symptoms, Prevention INTRODUCTION engue fever isa viral disease caused by Dengue virus belonging to the Flavi virus class of RNA viruses. Itis a debilitating disease found mainly in tropical areas. Its vector of transmission is a mosquito Aedes aegypti. Dengue virus is painful disease with fever, malaise and severe joint pains. For this reason itis also known as break bone fever, Severe form of dengue fever is known as Dengue hemorthagie fever which is characterized by bleeding from nose, gums and purpuric spots onthe body. Dengue virus infection is an upcoming Public health problem of global importance. Ithas become endemic in ‘more than 100 countries."This life threatening condition is spreading throughout the world at an alarming rate. These countries are facing frequent epidemics of dengue and dengue hemorrhagic fever, which is of great ‘concern to the health authorities, Pakistan in particular is facing increased frequency of the infection in recent years Dengue virus is believed to affect 50-100 million people, Annual no of eases with DHF are estimated to range from 20,000 to $00,000 per year. The case fatality rate of DHF and DSS is around 5 to 7%. "In Asia, dengue started from Southeast Asian countries and its spread was seen towards western geographic territory." Correspondence: Dr. Zoofishan Imran Assistant Professor Department of Community Medicine CMI Lahore Medical college and Institute of Dentistry Lahore Email:zoofishangureshi@hotmail.com Since then multiple outbreaks have been reported from different regions of India, Sri Lanka, Pakistan, and other Asian countries, The first confirmed dengue hemorthagic fever outbreak in Pakistan occurred in 1994, Epidemic of dengue infection was present in southern Pakistan for two years.” During 2005-2006, DHF activity was clearly in excess of its expected level leading to dengue outbreak in the country, with a large number of cases being reported from Karachi, More than 3,640 patients with signs and symptoms of dengue fever ‘were admitted to several referral hospitals in the country, and 40 were reported dead and 37 of these deaths occurred in Sindh. Most ofthe cases were from the east, centerand north of Karachi.” There is now evidence that co-circulation of DEN-2 and. DEN-3 was responsible for the 2006 out-break.’ Some studies showed significant association of male gender with DITF who were effected more than the females but higher mortality was however seen in females. Different studies have shown that children are affected less." In recent past, certain public health education programs have been launched to develop awareness and precautionary attitude in the community with regards to dengue fever to lessen the burden of disease. Researches on knowledge, attitude and practices about dengue in many endemic countries have shown that it hhas impact on vector control and other preventive practices." ‘There is dearth of data on knowledge, attitudes and practices (KAP) of the population regarding dengue fever, Despite the increasing incidence of dengue fever in Pakistan in recent years, only few studies have been conducted so far. This study was therefore undertaken to evaluate awareness regarding Dengue fever. Journal of CMH Lahore Medical College, Pakistan 2017; Volt(01):36-38 5“oofishan ran, Hairs Hire Zh, Maile Saboor Nasser Dengue is one of the major re-emerging viral infections ‘There has been a considerable increase in the geographic spread, number of cases and severity of the disease in the past decade, since there is a drastic change in the environment due to rapid urbanization and increase in transportation facilities in several parts of Pakistan. OBJECTIVES We aimed to assess knowledge of medical students about dengue, its spread and prevention. MATERIALS AND METHODS It was a descriptive cross sectional study which was cartied out in CMHLMC. The questionnaires were distributed among 200 students of both genders between 20-25 years of age by systematic random sampling technique. Sample size was calculated by WHO calculator. The students were selected from first to fifth year M.B.BS. Factors associated with causation and spread of dengue fever were evaluated by structured questionnaire, Data entry, analysis and presentation was, done using SPSS version 20. Data was presented in the form of frequency tables and graphs. It was a descriptive cross-sectional study so no test of significance was, applied, RESULTS ‘This study was conducted to assess the knowledge awareness and practices regarding dengue fever in the students of CMH LMC. Out of total participants in our study there were 51% males and 49% females (fig2). It was observed that all the respondents had heard about dengue. Knowledge of vector, transmission, spread and management of dengue were evaluated by self administered structured questionnaire. Seventy four percent of respondents were familiar with causative agent of dengue which is a virus while 3.5% said it is spread by bacteria, Nineteen percent were of the ‘opinion thatitis spread by parasite and 3.5% said that itis, caused by any other organism (table 1). Majority of the students knew about its mode of transmission and spread. Ninety five percent say it is transmitted by mosquito while 3.5% say itis due to flies and 1 % says itis via any other organism (table 2) Three manifestations of dengue are currently known as dengue fever, dengue haemorrhagic fever and dengue shock syndrome. Our sample show considerable good knowledge about symptoms. Eighty three percent knew about signs and symptoms of dengue, only 10 said they don't know and 3 % said these are not the symptoms of dengue (fig 3) Most important role in providing knowledge about dengue seems to be laid by media including T.V and newspapers. Seventy five percent participants came to know about dengue by media, 15% by book, 9% by relatives/friends and only 1% said they got the information about dengue from a doctor.(fig!) Knowledge about treatment of dengue among the respondent showed that 51.1% say that itis symptomatic while 15% say that it is treated by antibiotics and 3.5% say itis treated by antiviral (fig 4), DISCUSSION Health care providers can be very effective in imparting health education to the community. But their sound knowledge about the health issue is very important Medical students can play an important role in creating awareness about dengue infection among general public provided they themselves have good understanding of the health issue and its prevention ‘Our results assessed the knowledge of medical students regarding dengue. Such researches have been found to be very helpful in making strategies and policies for control and prevention of dengue.” The Indonesian ministry of health communicable disease centre (CDC), in conjunction with WHO has established mass health education programs to increase awareness and reduce larvabreeding sites.” Majority of the respondents in the study were aware of the causative agent and its mode of spread but evaluation of knowledge of management of dengue showed comparatively less awareness among medical students. Some were of the opinion that antibiotics and antiviral are the drug of choice. This finding correlates with another study showing that clinicians have a better understanding of pathophysiology of dengue than the clinical diagnosis and management." Adequate knowledge about dengue symptoms has been reported in similar study done in Civil Hospital, Karachi. Ninety one percent students were aware of prevention and its effectiveness while 9% did not know about it.” Most important role in providing knowledge about dengue seems to be laid by media including T.V and newspapers. Seventy five percent participants came to know about dengue by media, 15% by books and 9% by relatives. A similar study conducted among nursing students of a tertiary care hospital in India showed that among 201 students, almost all (94%) students had heard of dengue fever and many students derived this information from media. Other sources were teachers, doctors, family and friends. Overall, 80.6% were aware that dengue spreads by mosquito bites. Based on cumulative scoring for knowledge, attitude and practice of each respondent assessed, 57.2% had satisfactory knowledge on the symptoms, management and Journal of CMH Lahore Medical College, Pakistan 2017; Vol1(01):35-38 6Knowledge and Awareness of Dengue in Students of CMH Medical and Dental College, Lahore transmission of dengue. ‘At present, dengue control and prevention require awareness of factors beyond those commonly seen in topical countries.” Many of the affected countries are poor and developing.” Realistic approaches for their infrastructure are required to be urgently developed. Well-targeted preventive strategies, population-based epidemiological studies as well as organized awareness programmes for both community and medical personnel are urgently required to control high morbidity and ‘mortality due to dengue. Changing characteristics of the disease require researcher's attention, Currently, there are no licensed vaccines for dengue, and promising candidates are progressing through clinical trials, Moreover, there is no specific drug available and treatment is only supportive. Hence, the knowledge of spread of the vector and the disease is still extremely important. CONCLUSION Our cross sectional study has shown in general a very good level of awareness about dengue fever among ‘medical students of CMHLMC. Increasing knowledge of students can be helpful in spreading public awareness about Dengue which is becoming a global problem due to its rapid spread and complications. Therefore, in order to prevent the spread of this disease and save our communities from its deadly complications we need to set some goals for spreading awareness among public about following the preventing measures. However, approach of prevention should be community oriented and not just individual base. We should aim to make our ‘community healthierand dengue free. ‘Tablet: Knowledge Of Students About The Causative Agent of Dengue Causative factor Frequency Percentage Virus 8 74.0% Bacteria 7 35% Parstes 38 19.0% Otere 7 3% “Total 200 100.0% | Knowledge Of Students About The Vector Of Dengue Causative factor Frequency Percentage Mosquito 11 955% Flies 7 3% Other 2 10% Total 200 100.0% fig.3: Sources of information about Dengue Fig.2 Gender ostibution Journal of CMH Lahore Medical College, Pakistan 2017; Vol1 (01):35-38 Ts“oofishan orn, Hara Hire Zh, Maile Saboor Nass Fig: knowledge of symptoms among students Fiesckoowledge about manage of dengue oong studes regs REFFERENCES ‘Akram D S, Ahmed S. Dengue Fever Infeet Dis J 2005; 14 124s [Asan T. Dengue fever: 2008; 58: 1-2 regular epidemic? J Pak Med Assoe Guha-SapirD, Sehimmer B, Dengue Fever: new paradigms for changing epidemiology. Emerg Themes Epidemiol 2005; 2: Khan B, Siddiqui J, Stakoor S, Mebraj V, Jamil B, Hasan R. 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