title: A knowledge, attitude and practices study of the issues of climate change/variability impacts and public health in Trinidad and Tobago, and St Kitts and Nevis.
abstract: OBJECTIVE
  To determine the level of understanding of the issues of climate change (CC)/variability (CV) and public health by populations of St Kitts and Nevis (SKN) and Trinidad and Tobago (T&T) and to find whether respondents would be willing to incorporate these values into strategies for dengue fever (DF) prevention.
  
  
  METHODS
  Using a cluster sampling system, representative samples of the communities of SKN (227) and T&T (650) were surveyed for responses to a questionnaire document with questions on the impact of climate variability on health, the physical environment, respondents' willingness to utilize climate issues to predict and adapt to climate variability for DF prevention. Data were analyzed by Epi Info.
  
  
  RESULTS
  Sixty-two per cent SKN and 55% T&T of respondents showed some understanding of the concept of climate change (CC) and distinguished this from climate variability (CV). With regard to causes of CC, 48% SKN and 50% T&T attributed CC to all of green houses gases, holes in the ozone layer burning of vegetation and vehicular exhaust gases. However some 39.3% SKN and 31% (T&T) did not answer this question. In response to ranking issues of life affected by CC/CV in both countries, respondents ranked them: health > water resources > agriculture > biodiversity > coastal degradation. The major health issues identified for SKN and T&T respondents were: food-borne diseases > water-borne diseases > heat stresses; vector-borne diseases were only ranked 4th and 5th for SKN and T&T respondents respectively. There was in both countries a significant proportion of respondents (p < 0.001) who reported wet season-related increase of DF cases as a CC/CV link. Respondents identified use of environmental sanitation (ES) at appropriate times as a method of choice of using CC/CV to prevent DF outbreaks. More than 82% in both countries saw the use of the CC/CV information for DF prevention by prediction and control as strategic but only 50-51% were inclined to become personally involved. Currently, only 50% SKN and 45% T&T respondents claimed current involvement in DF vector surveillance and control in the last two days.
  
  
  CONCLUSIONS
  Despite the fact that knowledge and attitudes did not always coincide with practices of using ES for DF prevention, in both countries, even with CC/CV tools of prediction being available, it seems that respondents could be persuaded to use such strategies. There is a need for demonstration of the efficacy of CC/CV information and promotion of its usefulness for community involvement in DF and possibly other disease prevention.
authors.affiliation: Caribbean Epidemiology Centre, Port of Spain, Trinidad and Tobago, rawlinsaiacc@wow.net
authors.forename: S C
authors.initials: SC
authors.lastname: Rawlins
authors.forename: A
authors.initials: A
authors.lastname: Chen
authors.forename: J M
authors.initials: JM
authors.lastname: Rawlins
authors.forename: D D
authors.initials: DD
authors.lastname: Chadee
authors.forename: G
authors.initials: G
authors.lastname: Legall
mesh_terms: D000293:Adolescent; D000328:Adult; D003625:Data Collection; D003715:Dengue / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D017752:Greenhouse Effect; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D011634:Public Health / Q000639:trends*; D012111:Residence Characteristics; D019437:Saint Kitts and Nevis / Q000453:epidemiology; D040241:Social Marketing; D011795:Surveys and Questionnaires; D014300:Trinidad and Tobago / Q000453:epidemiology