CONTRIBUTING FACTORS TO THE INCREASING RATE OF DENGUE CASES IN

SELECTED BARANGAY IN ORMOC CITY

A Research Study
In Partial Fulfillment of the Requirement in
PRACTICAL RESEARCH II

ICT/CSS: A GROUP III

Amistad, Erwin C.
Canoy, Lovely Esther L.
Ecot, Jill T.
Felizardo, John Joseph
Cabatingan, Luiz Matthew,
Torralba, Grectchen,
Ipil, Rodel
Castillo, Ejay Mark L.
Claros, Shalie Charvin,
Balili, Mel John Paul

Approved by:

MS. JANICE Q. YAP LPT

Practical Research Instructor

DATE: _______________________
 CHAPTER I

INTRODUCTION

Nature and importance of the study

The research study is all about the contributing factors that increase the number of

dengue victims in Ormoc City, and what actions did the DOH (Department of Health) to

minimize this dengue cases.

As the world getting older, there are many Viruses spread in the world. One of them is

Dengue. According to [CITATION Den17 \l 1033 ] dengue viruses originated in monkeys and

independently jumped to humans in Africa or Southeast Asia between 100 and 800 years ago.

Dengue is very dangerous and simple disease because the victim just has fever, they thought its

normal but then again it’s a dengue.

The Department of health (DOH) have their actions to prevent dengue cases. Like the

free Dengue Vaccination. Dengue Vaccine is used to help protect a child against dengue caused

by dengue virus serotypes 1, 2, 3 and 4. It is administered via subcutaneous injection in the

upper arm (deltoid).

There are factors that can cause dengue. The dirty surroundings, storing plastics with

water, keeping car wheels, and unhealthy life style.

Sometimes, symptoms are mild and can be mistaken for those of the flu or another viral

infection. Younger children and people who have never had the infection before tend to have

milder cases than older children and adults. However, serious problems can develop. These

include dengue hemorrhagic fever, a rare complication characterized by high fever, damage to
lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and failure

of the circulatory system. The symptoms may progress to massive bleeding, shock, and death.

This is called dengue shock syndrome (DSS). People with weakened immune systems as well as

those with a second or subsequent dengue infection is believed to be at greater risk for

developing dengue hemorrhagic fever.

Primary prevention which includes use of mosquito repellents, mosquito bed nets,

mosquito coils, protective clothing and regularly removing sources of stagnant water to prevent

mosquito breeding is suggested as the most effective measure in dengue prevention and control.

Ultra low volume fogging or conventional space spraying of chemical insecticides is carried out

by the City Council in areas where there is a reported dengue outbreak. The success of efforts for

prevention and control of dengue in the community, however, relies on the effectiveness of

initiatives to educate the public about dengue and how it spreads, control of Aedes spp mosquito

breeding sites by the general public and improving household environmental sanitation, water

supply, and through sustained modification of human behaviour generally known as the

Communication for Behavioural Impact (COMBI). It has long been recognized that socio-

demographic characteristics, beliefs and practices about dengue have an impact on dengue

prevention and control. Socio-demographic factors such as age, education and marital status

influence the dengue prevention and control behavior. In earlier studies, Al-Dubai et al. found

that those in the 31 to 40 year-old age group had higher dengue prevention practices in

comparison to those aged 18 to 30 and to those aged ≥ 41 years. In addition, married couples

reported higher dengue prevention practices compared to single people. These support the

suggestion that individual’s health beliefs are likely to shape health care practices and often

associated to health prevention behaviours. The Health Belief Model (HBM), one of the most
widely used social cognition models to predict health behaviours, posits that individual's health

behaviour is determined by four main elements: i) consideration of likelihood (susceptibility); ii)

consideration of the seriousness (severity) of illness; iii) perceived benefits of taking health

action; and iv) perceived barriers to taking health action. These four perceptions are elements

that determine the readiness to take action and are activated by: i) cues to action and ii) self-

efficacy [8]. The HBM has been used as a framework for understanding how to effectively

structure health communication messages in order to change individual behaviour to prevent

dengue.

Additionally, knowledge and awareness factors are also associated with prevention

against dengue. Individuals with higher knowledge of dengue reported significantly higher

practices of prevention measures than those with low knowledge about dengue. Nevertheless,

there is also contrasting evidence that implies that knowledge about dengue does not always

result in the adoption of recommended preventive behaviours. Past research conducted in

Malaysia found that Malaysians generally have good knowledge of dengue and its prevention.

Nevertheless, little is known about the association between knowledge and prevention

behaviours relevant to dengue.

Objectives of the study:

This study aims to find out the Contributing factors to the increasing rate of

dengue cases in Ormoc City. Specifically;

1. To project the increasing number of dengue victims from the year 2014 –

2017,

2. To know which barangay in Ormoc City has the highest rate of dengue cases,
3. To know the age bracket of the easily contracted victims.
 CHAPTER II

REVIEW OF RELATED LITERATURE

Disease nowadays is very unpredictable just like dengue, it’s a normal fever but then

again it’s a disease that can kill human. Dengue is a debilitating viral disease of the tropics,

transmitted by mosquitoes, and causing sudden fever and acute pains in the joints. There are

symptoms that would clarify if you have a dengue according to [CITATION Placeholder1 \l 1033 ]

Dengue fever is transmitted by the bite of an Aedes mosquito infected with a dengue virus. The

mosquito becomes infected when it bites a person with dengue virus in their blood. It can’t be

spread directly from one person to another person. Symptoms, which usually begin four to six

days after infection and last for up to 10 days, may include: Sudden, high fever, Severe

headaches, Pain behind the eyes, Severe joint and muscle pain, Fatigue, Nausea, Vomiting, Skin

rash, which appears two to five days after the onset of fever, Mild bleeding (such a nose bleed,

bleeding gums, or easy bruising).

Dengue is a mosquito-borne infection of particular health importance in Asia, the

Americas and the Western Pacific. The infection has become endemic with frequent epidemic

outbreaks in many parts of the tropics and subtropical regions of the world. The World Health

Organization (WHO) currently estimates there may be 50–100 million dengue infections

worldwide every year including at least 500,000 dengue cases and 22,000 deaths, mostly among

children. In Malaysia, dengue is endemic with frequent major outbreaks notably in urban areas.

Dengue is rated the most important communicable disease in Malaysia, superseding tuberculosis,

malaria and HIV/AIDS. The number of dengue cases reported was 21,900 in 2012 and 43,346 in

2013, representing an increase of over two fold in a one-year period. As of August 2014, the
number of suspected dengue cases has exceeded 60,000 proving to be the biggest outbreak yet of

dengue in Malaysia.

Factors That Can cause dengue according to [ CITATION She17 \l 1033 ] House type and

Inhabitant density- Homes that are low-rise and clustered together are densely populated

enabling easy mosquito transmission of infections between households. Researchers in Brazil

showed that a high population density of low socioeconomic status, insufficient garbage

collection and water supply provide ideal conditions for mosquito proliferation, especially Aedes

aegypti. In Thailand, villages near deciduous forest, horticulture and perennial areas strongly

correlate with dengue indices. The density of vegetation is also a potential habitat for Aedes spp.

There is a higher chance of dengue outbreak occurring in areas where mosquito density is high.

Mosquito density is a primary determinant for practicing mosquito avoidance measures. Papua

New Guineans often sleep under a mosquito net when there an abundance of mosquitoes during

the rainy season. In Africa, villagers use mosquito coils, spray and bed nets primarily because of

annoyance from mosquito bites rather than the intent to prevent dengue or malaria.

Poor sanitation and hygiene for three-fold rise in dengue cases These mosquitoes breed

in clean water, often stored in overhead tanks or accumulated in scrap tubes and tyres of vehicles

for more than a week. Dengue infection rates are higher outdoors and during daytime, when

these mosquitoes bite most frequently.

The medical fraternity attributed the rise in the number of patients to the lack of personal

hygiene among people and governments failure to provide basic amenities of proper drainage

system and safe drinking water. The World Health Organisation (WHO) has said that the
environmental changes in the world are leading to an increase in the breeding of vectors and is a

cause of concern for the spread of vector-borne diseases across the globe.

Population Density [ CITATION had17 \l 1033 ] Metro Manila is the capital of the

Republic of the Philippines and is officially called the National Capital Region (NCR). It is

populous, urbanized and the most densely populated having over eleven million (11,855,975)

of Philippines’ ninety-two billion (92,337,852) people (NSO, 2012). It has a land area of

six hundred thirty six (636) sq. kilometers accounting for approximately 0.2 per cent of the

country’s total land area (Ragragio, 2003). The metropolis is divided into 17 cities and 1,687

barangays. Because of the highly urbanized and populous area of this region, it has the highest

recorded number of dengue vases in the Philippines. Metro Manila have selected areas with

very high crowding index especially those areas wherein “barong-barong” occurs. With

this, diseases can be easily transmitted from one person to the other especially mosquito-

borne diseases such as Dengue. The mosquito vector has an anthrophilic nature, wherein its

reproductive development is achieved in sustaining a human blood meal. According Gubler

and Ooi (2008), an increase in population has an inevitable effect on the citizens that may

lead to an increase in the need of good housing, clean water, sewage and waste management

creating ideal conditions for the vector. The impact of economic expansion and urbanization

indicates increased movement of people in between cities and regions (Gubler, 1997). Rapid

increase of population affects dengue cases and other epidemic diseases as well such as

population growth, public transportations and minor and major changes in infrastructures.

Climatic conditions and Flood prone areas Temperature and the presence of water play

a big role in the mosquito development and its spread. In the light of climate change, temperature

and precipitation rate in the Philippines has drastically changed and had become unpredictable
for the past years. These unpredictable changes may contribute also to the changing biology of

the mosquito, thus, it may strengthen their vectoral capacity to transmit the dengue virus

(Mohammed and Chadee, 2011). To address such, our research conducted a simulation of

observing developmental changes of the dengue vector subjected to different diurnal temperature

changes. It was shown that higher temperatures promoted faster development of the mosquito

(Figure 3a) and may influence sex ratio (Figure 3b). The results presented may mimic the

temperature ranges of the rainy season of the Philippines, thus, its development is hastened.

From this, high mosquito abundance is observed. Our mosquito surveillance in 2011 shows that

when the rainy season months start, there has been observed increase of abundance of

mosquito population (Figure 4). These findings are also congruent to the dengue cases

presented in 2010 (DOH, 2012). It was shown earlier that parts of Metro Manila are considered

to be flood prone areas (Figure 5) wherein some of these areas have very high dengue

incidence. Floods may indirectly lead to an increase in vector-borne diseases through the

extension in the number and range of vector habitats. Standing water instigated by heavy rainfall

or overflow from the bodies of water can exploit as breeding places for mosquitoes. The risk

of outbreaks is greatly amplified by complicating factors, such as variations in human behavior

(increased exposure to mosquitoes while sleeping outside, a temporary pause in disease control

activities, overcrowding), or changes in the habitat that promote mosquito breeding

(landslide, deforestation, river damming, and rerouting) (WHO, 2013).

Presence of artificial water-holding containers. The life cycle of Ae. aegypti mosquito

has two phases, the aquatic phase (larval and pupal stage) and the terrestrial phase (adult and

egg stage) (Centers for Disease Control and Prevention [CDC], 2012a). Highly associated

with humans and urban areas, these mosquitoes rely on people for the completion of their
development. Humans also provide artificial water-holding containers (AWHC) that serve as the

mosquito’s niche as it completes its life cycle. Several studies have shown that Ae. aegypti breed

in 37 kinds of man-made water-holding containers (Please see supplemental materials, Table 1

and Table 2). In our preliminary survey of larval Ae. aegypti mosquitoes, it has shown that

ceramic vases, plastic pails or containers and plastic drums are the most common breeding

sites from 72 households in selected areas of Metro Manila. It is noteworthy to mention that

regardless of water level, these mosquito can breed and establish a niche. Such findings are

consistent with literature and thus recommend that proper management of household owners who

has these containers to be very vigilant in physical control such as removal of water in these

containers.

Presence of vegetation In most literature in regards to the vector biology of Aedes

aegypti, there is a scarcity of material that would look into the presence of vegetation as a key

component in the biology of the vector. However, it will tackle more of the presence of small

plants in ceramic vases or pots that can attribute in becoming a water holding container suited for

the development of mosquitoes (Figure 7). The assembly of these containers that holds plants are

common niches of mosquitoes because of its ability to hold water. Another plant type that

has become popular in Metro Manila, especially used for landscaping and as ornamental

plants either inside or outside households, is the Bromeliad plants (Figure 8). This plant is

considered to be exotic in the Philippines (dela Cruz, 2001) and native to the Americas. The

anatomy of the plant itself is designed in a way to capture water itself. The researchers have

observed and collected in some houses different flying insects especially mosquitoes in the

areas of the plant wherein water is collected. Thus, increasing the mosquito population wherein it

can be efficient vectors of disease.

 Households Households have been main focal area of interest for mosquito

breeding sites. The researchers determined household characteristic and surrounding factors

would deem to be conducive for mosquitoes. In our preliminary survey of households in selected

areas of Metro Manila, among the household factors highly associated to mosquito

occurrence include households located near crowded areas, presence of pests, having pots or

vases, having big and open windows or doors, having humid air and warm temperatures.

Moreover, it is interesting to further emphasize are the other household factors were associated

to the non-occurrence of mosquitoes in the household. These are having screens and

curtains on windows, presence of sunlight inside and outside of the household, having sufficient

lighting in the house, and cooler

 CHAPTER III

THEORETICAL FRAMEWORK & CONCEPTUAL FRAMEWORK

Conceptual Framework

Figure 1:

Figure 1

The factors under independent variable which is the cause to the dependent variable

which is “Increasing number of dengue victims”. The intervening variable which cause changes
to the variables the dependent and independent. This factors under the independent variables are

the main cause why there’s a dengue.

Research Hypothesis

Ho: There is no significant evidence that the contributing factors can increase the rate of

dengue case in selected barangay in Ormoc City.

H1: There is a significant evidence that the contributing factors can increase the rate of

dengue case in the selected barangay in Ormoc City.

 OPERATIONAL DEFINITION OF TERMS

1. DENGUE- Dengue is a debilitating viral disease of the tropics, transmitted by

mosquitoes, and causing sudden fever and acute pains in the joints.

2. VIRUS-Virus is an infective agent that typically consists of a nucleic acid molecule in a

protein coat, is too small to be seen by light microscopy, and is able to multiply only

within the living cells of a host.

3. VACCINATION-Vaccination is a treatment with a vaccine to produce immunity against

a disease; inoculation.

4. DENGUE HEMORRHAGIC FEVER-Dengue hemorrhagic fever (DHF) is a syndrome

due to the dengue virus that tends to affect children under 10, causing abdominal pain,

hemorrhage (bleeding) and circulatory collapse (shock).

5. DENGUE FEVER-is a mosquito-borne tropical disease caused by the dengue virus.

Symptoms typically begin three to fourteen days after infection.

 CHAPTER IV

METHODOLOGY

Locale of the study

The locale of the study was conducted in Brgy. Punta Ormoc City. Where there are many

reported case of dengue victims.

Research Design

The type of research used in this study is Quantitative Research because we identify the

increasing rate of dengue cases in Brgy. Punta Ormoc City.

Respondents and Sampling Procedure

The Respondent of the study is the Barangay Health Workers in Brgy. Punta Ormoc City.

The team randomly give the survey questionnaire to the health workers in Brgy. Punta Ormoc

City. So all in all we have 10 Respondents.

Research Instrument

This study used a survey questionnaire to collect data. The questionnaire have 20

questions. Combine with open and closed question.

Data Gathering Procedure

The data for this research were collected using survey questionnaire. The said

respondents were given time to answer and we will wait them. the team will collect the

questionnaire after they answered.

 LITERATURE CITED

Carvajal, h. (2017, August 25). NVIRONMENTAL DETERMINANTS IN THE CONTROL OF

DENGUE MOSQUITO VECTOR, Aedes aegypti. Retrieved from researchgate:
https://www.researchgate.net/publication/274065283_ENVIRONMENTAL_DETERMI
NANTS_IN_THE_CONTROL_OF_DENGUE_MOSQUITO_VECTOR_Aedes_aegypti

Dailisan, S. (2017, August 5). Retrieved from Center fro disease control and prevention:
https://www.cdc.gov/dengue/epidemiology/index.html

Dailisan, S. (2017, July 31). Retrieved from WebMD: http://www.webmd.com/a-to-z-

guides/dengue-fever-reference#1

Dengue Fever Cases rise in the Philippines. (2017, July 31). Retrieved from
Interhealthworldwide.org: https://www.interhealthworldwide.org/home/health-
resources/health-alerts/2016/july/07/dengue-fever-cases-rise-in-the-philippines/

Enriquez, M. C. (2017, July 31). Dengue vaccine now in the Philippines. Retrieved from
Inquirer.net: http://lifestyle.inquirer.net/260118/dengue-vaccine-now-philippines/

Jaymalin, M. (2016, December 2). DOH to distribute condoms in schools . Retrieved from The
Philippine Star: http://www.philstar.com/headlines/2016/12/02/1649587/doh-distribute-
condoms-schools

Lu, S.-N. (2017, August 25). Factors Affecting Dengue Prevention Practices: Nationwide
Survey of the Malaysian Public. Retrieved from PMC:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383514/

MM, R. (2017, August 7). Retrieved from NCBI:

https://www.ncbi.nlm.nih.gov/pubmed/25163973

Staff, M. C. (2017, July 31). Prevention. Retrieved from Mayoclinic.org:

http://www.mayoclinic.org/diseases-conditions/dengue-fever/basics/prevention/con-
20032868

What is dengue vaccine? (2017, August 6). Retrieved from doh.gov.ph:

http://www.doh.gov.ph/node/5588
APPENDICES
Appendix A. Letter

ACLC COLLEGE OF ORMOC

SENIOR HIGH SCHOOL DEPARTMENT

September 19, 2017

Hon. Agapito Inong
Barangay Captain
Punta, Ormoc City

Dear Hon. Inong,

Greetings! Our Practical Research II Instructor, Ms. Janice Yap gave us a task to conduct
a research entitled “Contributing Factors to the increasing rate of dengue cases in selected
Barangay in Ormoc City.

We would like to ask for your permission that we will conduct this study in your
barangay on September 23, 2017 Saturday around 8am to 2pm.

We are hoping for a positive feedback thank you and God Bless!

You can Contact us by this number and email,

09959722827 (Globe)
Erwin.amistad98@gmail.com

Sincerely yours,

ERWIN AMISTAD
Group 3 Leader

Approved by:

Janice Yap
Practical Research II Instructor
 Appendix A. Self-administered Questionnaire
ACLC College of Ormoc
Senior High School
“Contributing factors to the increasing rate of dengue cases in selected barangay in Ormoc City”

Purpose: The purpose is to identify the factors that cause increasing number of dengue victims and
the reactions of the victims.
Name: ________________ Age: __________ Gender: __________
Address: _____________________ Contact No.: _____________
Directions: Put a check (/) mark on the box if the question answerable by Yes or No and
put your answer on the space provided.

A. Questions Yes No
1. Are there areas that in your barangay that collect stagnant water?
2. Do you have any cleaning schedule in your barangay?
3. Does the health center of your barangay visit those who has in dengue?

4. Do you influence your people to clean their surroundings specially to the that collect
stagnant water
5. Do you think dengue can cause death?
6. Did your barangay give a prescribe medicine to the dengue victim
B.
7. What age are most affected by this disease? __________
8. Which time has the highest dengue attack? ____________________
9. In this year how many victims of dengue virus are infected? ________________
10. How many people affected by dengue in the year 2014? ____________________
11. How many people infected by dengue in the year 2015? ____________________
12. How many people infected by dengue in the year 2016? ____________________
13. What is the total dengue victim in the year 2014-2017? _____________________
14. What year has the highest rate of dengue cases? __________________
15. What year has the lowest rate of dengue cases? ___________________
16. What action do you make by projecting the increasing number of dengue in your
barangay? ____________________________________________________________
17. In your barangay, what do you observed to the person who have dengue?
____________________________________________________________
18. How many times do you have general cleaning in year?
19. What medicine can heal the dengue virus? ___________________________________
20. If so, how many people died because of this virus? ______________________--