Use of the Health Belief Model for the Assessment of Public Knowledge and Household Preventive Practices in Karachi, Pakistan, a Dengue-Endemic City.
BACKGROUND
Prevention is most effective in reducing dengue infection risk, especially in endemic countries like Pakistan. Evaluation of public awareness and health beliefs regarding dengue fever (DF) is important for devising disease control strategies. This study assessed dengue knowledge, health beliefs, and preventive practices against DF in different socioeconomic groups of Karachi, Pakistan.


METHODS
In this community-based cross-sectional study, 6 randomly selected towns were visited, 2 persons (man and woman) per household were interviewed using a structured questionnaire, and household practices were observed. Information regarding DF was shared through a printed pamphlet. Multivariate logistic regression analysis of variables associated with dengue knowledge and practices was conducted.


RESULTS
We interviewed 608 Karachi residents (mean age: 33.2 ± 13.35 years); 7.7%, 71.9%, and 20.4% had a high, middle, and low socioeconomic status, respectively. The mean knowledge score was 6.4 ± 2.10 out of 14. The mean preventive practices score was 9 ± 1.8 out of 17. Predictors of dengue knowledge were perceived threat (odds ratio [OR] = 1.802; 95% confidence interval [CI] = 1.19-2.71; p = 0.005), self-efficacy (OR = 2.910; 95% CI = 1.77-4.76; p = 0.000), and television as an information source (OR = 3.202; 95% CI = 1.97-5.17; p = 0.000). Predictors of dengue preventive practices were perceived threat (OR = 1.502; 95% CI = 1.02-2.19; p = 0.036), self-efficacy (OR = 1.982; 95% CI = 1.34-2.91; p = 0.000), and dengue knowledge (OR = 1.581; 95% CI = 1.05-2.37; p = 0.028).


CONCLUSIONS
Public knowledge about DF is low in Karachi. Knowledge, threat perception, and self-efficacy are significant predictors of adequate dengue preventive practices. Prevention and control strategies should focus on raising awareness about dengue contraction risk and severity through television. Health messages should be designed to increase individual self-efficacy.
Pakistan Health Research Council, PHRC Research Centre, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan.
Taranum Ruba
TR
Siddiqui
Pakistan Health Research Council, PHRC Research Centre, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan.
Saima
S
Ghazal
Pakistan Health Research Council, PHRC Research Centre, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan.
Safia
S
Bibi
Pakistan Health Research Council, PHRC Research Centre, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan.
Waquaruddin
W
Ahmed
Pakistan Health Research Council, PHRC Research Centre, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan.|Field Epidemiology & Laboratory Training Program (FELTP), Islamabad, Pakistan.
Shaimuna Fareeha
SF
Sajjad
D000328:Adult; D003430:Cross-Sectional Studies; D003715:Dengue / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology; D019353:Endemic Diseases / Q000517:prevention & control; D005191:Family Characteristics; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016017:Odds Ratio; D010154:Pakistan / Q000453:epidemiology; D011314:Preventive Health Services / Q000379:methods; D012044:Regression Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult