Practices of Dengue Fever Prevention and the Associated Factors among the Orang Asli in Peninsular Malaysia

journal (full version)
Josephine Rebecca Chandren1 , Li Ping Wong1,2*, Sazaly AbuBakar3,4

Abstract

Background

Dengue is prevalent among Malaysia's indigenous peoples, known as the Orang Asli, and it poses a serious health threat to them. The study aims to look at the socio-demographic fac- tors, health beliefs, and knowledge about dengue and its association to dengue prevention practices among Orang Asli communities in Peninsular Malaysia.

Methods

A cross-sectional survey was conducted in 16 randomly selected Orang Asli villages from eight states in Peninsular Malaysia from April 2012 until February 2013.

Results

A total of 560 Orang Asli were interviewed and 505 completed the survey. Slightly above half of the participants (n = 280, 55.4%) had a total dengue prevention score of 51–100 (of a possible score of 0–100). Multivariate analysis findings showed dengue knowledge, per- ceived barriers to perform dengue prevention, fogging frequency, and perceived suscepti- bility to dengue fever as significant factors associated to dengue prevention practices. Participants with a lower dengue knowledge score (score 0–18) were less likely (OR = 0.63, 95%CI = 0.44–0.92 vs. score 19–36, P = 0.015) to practice dengue prevention. Participants with low perceived barriers to prevent dengue (score of 1–5) were more likely (OR = 2.06, 95%CI = 1.21–3.53, vs. score of 6–10, P = 0.008) to practice dengue prevention. Villages that were not fogged (OR = 0.49, 95%CI = 0.24–0.99, P = 0.045) or rarely fogged (OR = 0.40, 95%CI = 0.22–0.75, P = 0.004) had lower dengue prevention practices than villages that were fogged often. Participants with low perceived susceptibility of acquiring dengue (score of 1–5) were less likely (OR = 0.54, 95%CI = 0.33–0.89 vs. score of 6–10, P = 0.018) to practice dengue prevention measures. 

Conclusion

Findings imply that educational and health programmes should focus on enhancing dengue knowledge and perceived susceptibility of acquiring dengue and reducing perceived barri- ers to performing dengue prevention practices among the Orang Asli. More outreach on mosquito control campaigns should be carried out especially in villages where mosquito fogging is frequent.

Opinion
This study is aimed to examine these factors and their association with dengue prevention practices. A cross-sectional survey was conducted among 16 randomly selected Orang Asli villages from 8 states in Peninsular Malaysia. Results showed that :

1. level of dengue knowledge, 
2. perceived barriers to perform dengue prevention,
3. fogging frequency, and
4. perceived susceptibility to dengue fever are significant factors of dengue prevention practices. Findings provide important insights into intervention to increase dengue prevention practices among the Orang Asli community

From this study, several conclusions could be inferred with important implications for dengue fever prevention practices. 

Firstly, the findings indicate that the level of knowledge about dengue fever, signs and symptoms, and prevention among the participants was low. 

Secondly there were significant differences of knowledge scores in different religions, states, occupations, average monthly incomes, and types of house. 

Thirdly, dengue knowledge level, perceived barriers to perform dengue prevention, fogging frequency, and perceived susceptibility to dengue fever were significant factors associated with dengue prevention practices.

Dengue control would be more effective if the community understands very well about the disease, how the disease transmitted, and  the characteristics of the vector.