|Year : 2015 | Volume
| Issue : 1 | Page : 16-19
A Study on Knowledge and Preventive Practices about Mosquito Borne Diseases in Delhi
Charu Kohli, Rajesh Kumar, Gajendra S Meena, Mongjam M Singh, Gopal K Ingle
Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
|Date of Web Publication||27-Jan-2015|
Dr. Charu Kohli
Department of Community Medicine, Maulana Azad Medical College, New Delhi - 110 002
Source of Support: None, Conflict of Interest: None
Background: Mosquito-borne diseases constitute an important cause of morbidity and mortality, especially in India. Assessment of knowledge and practices of community about prevention of mosquito borne diseases is important for designing community-based interventions. Therefore, the study was carried out to assess such information. Materials and Methods: A community-based cross-sectional study was conducted among 350 adults selected by systematic sampling method in a rural and urban area in Delhi. Data was collected using pretested semi-structured questionnaire after taking written informed consent. Data was analyzed using SPSS version 17. Chi-square and Fisher's Exact test was used for qualitative variables to find association and P <</i> 0.05 was considered significant. Results: One hundred and forty-two (67.6%) subjects in rural and 89 (63.6%) in the urban area were able to name at least one mosquito borne disease. Only small number of participants (from rural 28.1% and urban 18.6% areas) was aware of "fever with chills and rigor" as a symptom of malaria. Television was most common source of information in both rural and urban areas. Desert coolers were reported to be cleaned regularly in a week in 86.4% houses in a rural area, and 88.4% houses in the urban area. Potential breeding sites were significantly more in urban (n = 34, 24.3%) than rural (n = 13, 6.2%) houses (P = 0.01). Similarly actual breeding of mosquitoes was found significantly more in urban houses (n = 29, 20.7%) than rural houses (n = 14, 6.7%), which was statistically significant (P = 0.01). Knowledge about mosquito borne diseases was significantly associated with education status of the participants. Conclusion and Recommendation: Level of awareness was good; however mosquito breeding was occurring more in urban areas, which demands innovative mass media techniques to convey health messages to the public for prevention and control of mosquito borne diseases.
Keywords: Delhi, knowledge, mosquitoes, preventive practices, vector borne diseases
|How to cite this article:|
Kohli C, Kumar R, Meena GS, Singh MM, Ingle GK. A Study on Knowledge and Preventive Practices about Mosquito Borne Diseases in Delhi. MAMC J Med Sci 2015;1:16-9
|How to cite this URL:|
Kohli C, Kumar R, Meena GS, Singh MM, Ingle GK. A Study on Knowledge and Preventive Practices about Mosquito Borne Diseases in Delhi. MAMC J Med Sci [serial online] 2015 [cited 2019 Feb 22];1:16-9. Available from: http://www.mamcjms.in/text.asp?2015/1/1/16/150054
| Introduction|| |
Mosquito borne diseases of public health importance are complex, and their occurrence depends on the interaction of various biological, ecological, social and economic factors. Malaria constitutes an important disease with annual occurrence of 300-500 million cases and 1.1-2.7 million deaths globally.  An estimated 96 million apparent dengue infections were reported globally in 2010. Asia bears 70% (47-94 million infections) of this burden whereas India alone contributed 34% (24-44 million infections) of the global total. 
Other mosquito borne diseases like chikungunya, lymphatic filariasis, and Japanese encephalitis are also important causes of morbidity and mortality. Looking at the seriousness of the situation, World Health Organization declared "vector borne diseases" as the theme for the year 2014 on World Health Day to highlight the importance of measures for prevention and community-based action.  Primary prevention of transmission of mosquito borne diseases is crucial to decrease the burden of diseases, especially in control of dengue, as it is the only available strategy. 
Knowledge and practices of community about prevention of mosquito borne diseases are an important aspect to assess the need of community-based interventions. In the same context, elimination of the breeding sites from the human habitat is the most effective way to manage mosquito borne diseases, hence social and behavioral interventions at household level are thought to be the most viable measures for these diseases. , The use of personal protective measures (PPMs) suh as mats, bednets, screening, repellents, liquid vaporizers, mosquito coils, etc., has been advocated as an effective tool in control of mosquito borne diseases.  Keeping in view the same, this study was planned with the objective to assess knowledge and preventive practices of the community regarding prevention and control of mosquito borne diseases in Delhi.
| Materials and Methods|| |
Ethical clearance was taken from institutional Ethical Committee. A community-based cross-sectional study was conducted in a rural area, Barwala located in the northwest district and an urban slum, Balmiki Basti of the central district in Delhi. Around 900 families reside in Barwala and 600 in Balmiki Basti. The sampling universe included all families residing in the above-mentioned areas for at least past 6 months. Sample size was calculated on the basis of results of a previous study where awareness among study subjects about mosquito borne diseases was 69%.  Taking 10% allowable error with 95% confidence interval, sample size came out to be 172. However, the study sample included a total of 350 families; 210 from the rural area and 140 from the urban area selected through systematic random sampling method. One adult was selected from each family. Data collection was done by door to door survey method. When a house was found locked even after three visits, next house was selected without disturbing the overall sampling procedure. Data was collected using pretested semi structured interview schedule. The schedule consisted of items on socio-economic and demographic profile of study subjects, knowledge about mosquito borne diseases and their preventive practices. Direct observation of the house and surroundings for the presence of potential mosquito breeding sites and control measures was done. Data regarding the use of PPMs like bednets, coils, liquid vaporizers, etc., was also assessed. Data analysis was done using Statistical package for the social sciences software (SPSS Inc Version 17.0, 2008. Chicago, USA). Chi-square test or Fisher's Exact test were used for finding an association between qualitative variables and P < 0.05 was considered significant.
| Results|| |
One hundred and forty-seven subjects (42%) were males, and 203 (58%) were females. Rural (51.4% and 28.1%) and urban (39.3%, 29.3%) subjects belonged to 18-29 years of age group and 30-39 years respectively. In rural area, 24.3% and in the urban area, 23.6% subjects were illiterate. Those educated up to middle school were 46 (21.9%) in rural and 30 (21.4%) in the urban area. Monthly per capita income (in Indian National Rupee) in a rural area was Rs. 3824.84 ± 2308.41 (standard deviation [SD]) and 2846.92 ± 1708.12 (SD) in urban area.
One hundred and forty-two (67.6%) subjects in rural and 89 (63.6%) in urban area were able to name at least one mosquito borne diseases but no significant difference was found in two areas (χ2 = 0.61, df = 1, P = 0.43). A total of 228 (65.1%) participants were aware of malaria, 218 (62.3%) named dengue, 35 (10.0%) named chikungunya and only 1 (0.3%) each was aware of Japanese encephalitis and yellow fever. There was no significant difference among males and females for their knowledge about mosquito borne diseases except chikungunya in which females (13.8%) have significantly higher knowledge as compared to males (4.8%) in rural area (χ2 = 7.72, df = 1, P = 0.01). Statistically significant association was found between education status and knowledge about mosquito borne diseases. When participants were asked if they knew the season in which mosquito related diseases are highest, 137 (65.2%) of subjects from rural area and 73 (52.1%) from urban area mentioned that it was highest in rainy season. Thirty Three percent subjects in rural and 47.1% in the urban area had no knowledge about seasonal variation of mosquito borne diseases. [Table 1] shows the results when participants were asked about symptoms of malaria; small number of participants were aware of "fever with chills or rigor" in both rural 59 (28.1%) and urban 26 (18.6%) areas and this difference was significant (χ2 = 4.14, df = 1, P = 0.04). Results were significant for response "vomiting" as well (χ2 = 4.65, df = 1, P = 0.03).
When study subjects were asked if they were aware of how mosquito borne diseases can be prevented, the responses given were: Prevention of stagnation of water (49.7%), covering water containers (41.1%), cleaning of coolers (21.1%), putting kerosene oil in coolers (12.0) and use of PPMs (5.7%) participants.
Regarding knowledge about PPMs, majority of participants were aware of coils in both rural (69.0%) and urban area (75.7%), however, only one third of subjects were aware of insecticide spray (rural 29.5%, urban 27.9%). Repellent cream was known to 46 (21.9%) rural and 36 (25.7%) urban area respondents. However, the results were not significantly different between rural and urban area except for response "mats" (χ2 = 6.00, df = 1, P = 0.01). Results were significantly different in various education classes for knowledge about coils, mats, liquid vaporizers and smoke.
[Table 2] presents the responses of subjects when they were asked for different sources of information about mosquito borne diseases and PPMs. One hundred and sixteen (55.2%) rural and 82 (58.6%) urban participants responded television was the main source of information. Radio was mentioned by 53 (25.2%) rural and 28 (20.0%) urban respondents. Hoarding and posters/pamphlets were also the source of information for 15.7% and 11.9% rural and 25.0% and 25.0% urban participants respectively. The differences were statistically significantly for "hoarding" and "posters/pamphlets" (χ2 = 4.62, P = 0.03 and χ2 = 10.14, P = 0.01).
|Table 2: Area wise distribution of sources of information about mosquito borne disease|
Click here to view
Observations about preventive practices are not given in table. Desert coolers were found in 103 (49.0%) of rural houses and 69 (49.3%) of urban houses. Coolers were reported to be cleaned regularly in a week in 89 (86.4%) houses out of 103 in a rural area. This figure was 61 (88.4%) in the urban area.
[Table 3] shows the observations of household and surroundings for conditions that can lead to breeding of mosquitoes. It was found that potential breeding sites were found in 13 (6.2%) rural and 34 (24.3%) urban houses which was statistically significant (χ2 = 23.65, P = 0.01). Actual breeding of mosquitoes was found in or around the house in 14 (6.7%) rural and 29 (20.7%) urban houses (χ2 = 15.38, P = 0.01). Adult mosquitoes were seen in 30 (14.3%) rural and 37 (26.4%) urban households (χ2 = 8.0, P = 0.01). Although 18 (13.6%) subjects in rural and 14 (16.1%) in urban areas mentioned that they use PPMs in daytime also but out of them, in only 11 (61.1%) rural and 8 (57.1%) urban households the PPMs were in use in daytime at the time of visit. This difference between rural-urban was not significant (χ2 = 0.93, P = 0.33). Larvicidal oil/kerosene was present in drains and coolers in only 54 (25.7%) rural and 16 (11.4%) urban houses (χ2 = 10.71, P = 0.01). Out of 15 (7.1%) rural and 5 (3.6%) urban houses, which reported using bednets, 11 (73.3%) in rural and 5 (5%) in urban area, the condition of bednets was satisfactory.
|Table 3: Observation about mosquitoes and breeding places in rural and urban areas|
Click here to view
| Discussion|| |
The present study shows that the knowledge about mosquito borne diseases was significantly associated with education status of the participants. This is consistent with findings of another study carried out by Sharma et al. where higher educational status was associated with the correct knowledge of spread of malaria by mosquitoes.  Knowledge about mosquito borne diseases did not significantly differ by gender. This is similar to findings of another study carried out by Van Benthem et al., where knowledge about dengue did not significantly differ by sex. 
Twenty-four percent participants were aware of "fever with chills or rigor" as a symptom of malaria. A higher number of rural area subjects were aware of this symptom as compared to the urban area. Similar finding was reported for symptom "vomiting". The findings were not significantly different in either sex. However, the results were significantly different in education classes. These results are different from the findings reported in another study conducted in Uttar Pradesh (UP) by Sood et al. where 82.0% of the villagers knew about the symptoms of malaria such as fever, cold and periodic shivering and 18.0% knew of vomiting, nausea, and headache.  The higher prevalence of malaria in UP may be a reason for more awareness of its symptoms among study subjects. Most common source of information in both rural (55.2%) and urban areas (58.6%) about mosquito borne diseases was television as shown by other studies also from Karachi and Kuala Kangsar District. , Radio and neighbors/friends were also important sources of information. Hoardings and posters/pamphlets were reported significantly more in the urban area as compared to the rural area as sources of information. Mass media was an important means of conveying health messages to the public even among the rural population, thus research and development of educational strategies designed to improve behavior and practices of effective control measures should be encouraged. There is a need to utilize these important methods of mass communication to raise the awareness about control and prevention of mosquito borne diseases.
The present study showed that 87.2% of participants who had coolers in their houses used to clean their desert coolers weekly. It is an important finding because desert coolers are the main source of mosquito breeding, and they should be cleaned weekly. It has been seen with previous studies that there is a significant association between knowledge and attitude toward mosquito control.  Kerosene or larvicidal oil was used in drains in only 20.0% of the houses only. This goes in line with another study done in Delhi by Acharya et al. where it was observed that 87.0% of study subjects used to adequately clean their coolers and 46.0% used to put oil in coolers adequately. 
Potential breeding sites, breeding of mosquitoes and adult mosquitoes were observed significantly more in the urban area. However, the present results are different from the findings of the study carried out by Rozhan et al.  in the district of Hulu Langat in 2006 where 24.3% or one in four affected households had breeding inside the house.  In another study carried out by Vijayakumar et al. in Kerela, it was found that stored drinking water was the most common potential breeding source in the houses.  Different studies have shown that water storage in the house and artificial collection in and around the house as frequent sites of mosquito breeding.  The study found conditions suitable for mosquito breeding and actual breeding sites in some of the houses.
It is thus recommended that innovative information, education, and communication activities should be carried out to raise the knowledge and promote preventive practices regarding prevention and control of mosquito borne diseases.
| Acknowledgment|| |
Authors are grateful for participants of the study for their contribution.
| References|| |
Boratne AV, Jayanthi V, Datta SS, Singh Z, Senthilvel V, Joice YS. Predictors of knowledge of selected mosquito-borne diseases among adults of selected peri- urban areas of Puducherry. J Vector Borne Dis 2010;47:249-56.
Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, et al.
The global distribution and burden of dengue. Nature 2013;496:504-7.
Vanlerberghe V, Toledo ME, Rodríguez M, Gomez D, Baly A, Benitez JR, et al.
Community involvement in dengue vector control: Cluster randomised trial. BMJ 2009;338:b1959.
Gubler DJ. Aedes aegypti and Aedes aegypti-borne disease control in the 1990s: Top down or bottom up. Charles Franklin Craig Lecture. Am J Trop Med Hyg 1989;40:571-8.
Leontsini E, Gil E, Kendall C, Clark GG. Effect of a community-based Aedes aegypti control programme on mosquito larval production sites in El Progreso, Honduras. Trans R Soc Trop Med Hyg 1993;87:267-71.
Boratne A, Datta S, Singh Z, Purty A, Jayanti V, Senthilvel V. Attitude and practices regarding mosquito borne diseases and socio demographic determinants for use of personal protection methods among adults in coastal Pondicherry. Indian J Med Specialities 2010;1:91-6.
Snehlata KS, Ramaiah KD, Kumar V, Das P. The mosquito problem and type and cost of personal protection as a measure used in rural and urban communities in Pondicherry region, South India. Acta Trop 2003;88:3-9.
Sharma AK, Bhasin S, Chaturvedi S. Predictors of knowledge about malaria in India. J Vector Borne Dis 2007;44:189-97.
Van Benthem BH, Khantikul N, Panart K, Kessels PJ, Somboon P, Oskam L. Knowledge and use of prevention measures related to dengue in northern Thailand. Trop Med Int Health 2002;7:993-1000.
Sood RD, Mittal PK, Kapoor N, Razdan RK, Dua VK, Dash AP. Community awareness, perceptions, acceptability and preferences for using LLIN against malaria in villages of Uttar Pradesh, India. J Vector Borne Dis 2010;47:243-8.
Itrat A, Khan A, Javaid S, Kamal M, Khan H, Javed S, et al.
Knowledge, awareness and practices regarding dengue fever among the adult population of dengue hit cosmopolitan. PLoS One 2008;3:e2620.
Hairi F, Ong CH, Suhaimi A, Tsung TW, bin Anis Ahmad MA, Sundaraj C, et al.
A knowledge, attitude and practices (KAP) study on dengue among selected rural communities in the Kuala Kangsar district. Asia Pac J Public Health 2003;15:37-43.
Acharya A, Goswami K, Srinath S, Goswami A. Awareness about dengue syndrome and related preventive practices amongst residents of an urban resettlement colony of south Delhi. J Vector Borne Dis 2005;42:122-7.
Rozhan S, Jamsiah M, Rahimah A, Ang KT. The COMBI (Communication for Behavioural Impact) program in the prevention and control of Dengue - The Hulu Langat experience. J Kesihatan Masyarakat 2006;12:1-14.
Vijayakumar K, Anish TS, Sreekala KN, Ramachandran R, Philip RR. Environmental factors of households in five districts of Kerala affected by the epidemic of chikungunya fever in 2007. Natl Med J India 2010;23:82-4.
Naing C, Ren WY, Man CY, Fern KP, Qiqi C, Ning CN, et al.
Awareness of dengue and practice of dengue control among the semi-urban community: A cross sectional survey. J Community Health 2011;36:1044-9.
[Table 1], [Table 2], [Table 3]