02781nas a2200241 4500000000100000008004100001260003000042653001300072653003900085653001900124653001100143653001400154100001600168700001300184700001100197700001200208700001400220245015400234856009800388300001300486490000700499520203300506 2016 d bPublic Library of Science10aPakistan10aNeglected tropical diseases (NTDs)10aHealth beliefs10aDengue10aAwareness1 aSiddiqui TR1 aGhazal S1 aBibi S1 aAhmed W1 aSajjad SF00aUse of the health belief model for the assessment of public knowledge and household preventive practices in Karachi, Pakistan, a dengue-endemic city. uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005129&type=printable ae00051290 v103 a

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.

METHODOLOGY: 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.

PRINCIPAL FINDINGS: 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.