Societal knowledge, attitude, and practices towards dengue and associated factors in epidemic-hit areas: Geoinformation assisted empirical evidence

Syed Ali Asad Naqvi, Muhammad Sajjad, Aqil Tariq*, Muhammad Sajjad, Liaqat Ali Waseem, Shankar Karuppannan*, Adnanul Rehman, Mujtaba Hassan, Saad Al-Ahmadi, Wesam Atef Hatamleh

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

3 Citations (Scopus)


Dengue is one of Pakistan's major health concerns. In this study, we aimed to advance our understanding of the levels of knowledge, attitudes, and practices (KAPs) in Pakistan's Dengue Fever (DF) hotspots. Initially, at-risk communities were systematically identified via a well-known spatial modeling technique, named, Kernel Density Estimation, which was later targeted for a household-based cross-sectional survey of KAPs. To collect data on sociodemographic and KAPs, random sampling was utilized (n = 385, 5 % margin of error). Later, the association of different demographics (characteristics), knowledge, and attitude factors—potentially related to poor preventive practices was assessed using bivariate (individual) and multivariable (model) logistic regression analyses. Most respondents (>90 %) identified fever as a sign of DF; headache (73.8 %), joint pain (64.4 %), muscular pain (50.9 %), pain behind the eyes (41.8 %), bleeding (34.3 %), and skin rash (36.1 %) were identified relatively less. Regression results showed significant associations of poor knowledge/attitude with poor preventive practices; dengue vector (odds ratio [OR] = 3.733, 95 % confidence interval [CI ] = 2.377–5.861; P < 0.001), DF symptoms (OR = 3.088, 95 % CI = 1.949–4.894; P < 0.001), dengue transmission (OR = 1.933, 95 % CI = 1.265–2.956; P = 0.002), and attitude (OR = 3.813, 95 % CI = 1.548–9.395; P = 0.004). Moreover, education level was stronger in bivariate analysis and the strongest independent factor of poor preventive practices in multivariable analysis (illiterate: adjusted OR = 6.833, 95 % CI = 2.979–15.672; P < 0.001) and primary education (adjusted OR = 4.046, 95 % CI = 1.997–8.199; P < 0.001). This situation highlights knowledge gaps within urban communities, particularly in understanding dengue transmission and signs/symptoms. The level of education in urban communities also plays a substantial role in dengue control, as observed in this study, where poor preventive practices were more prevalent among illiterate and less educated respondents.

Original languageEnglish
Article numbere23151
Number of pages16
Issue number1
Early online date13 Dec 2023
Publication statusPublished - Jan 2024

Scopus Subject Areas

  • General

User-Defined Keywords

  • Dengue fever (DF)
  • KAPs
  • Epidemiology
  • Cross-sectional study
  • Spatial analysis
  • Rawalpindi
  • Community awareness


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