Widespread fear of dengue transmission but poor practices of dengue prevention: A study in the slums of Delhi, India

BackgroundThis study has been conducted to throw light on the knowledge and practices related to dengue fever among the poor population living in Delhi’s slums.MaterialsA household survey was conducted in 2013 among 3,350 households. The households were stratified by a number of variables related to socio-economic status and health events such as hospitalisation. The data collection was completed through face-to-face interviews conducted with the help of 25 field investigators.ResultsAbout 8% of the households had at least one diagnosed dengue case. In comparison to the population surveyed, teenagers (15–19 years) and adults (30–34 years) were more affected whereas children under four years of age were underrepresented. Housewives are more affected by dengue (24%) compared to their share of the population surveyed (17%). Despite the fact that 77% of the respondents are worried about mosquitoes, only 43% of them monitor environment to avoid the presence of breeding sites.ConclusionOne cannot exclude the possibility that though young children under the age of four years are exposed to the virus, either their cases were asymptomatic or family members infected during this period had potentially more serious symptoms leading to hospitalisation. This result could thus be explained by budget-related health choices made by this population which do not favour small children. Educational programs should target housewives to improve their impact, as they are the ones mostly responsible for water storage and cleanliness of the house and its neighbourhood. Even with a dengue experience and potentially an acute perception of the risk and its factors, a proper management of environmental conditions is lacking. This along with the fact that word-of-mouth is the main source of information quoted should be a message for municipality health workers to give door-to-door information on how to prevent breeding sites and dengue infection.

研究背景：本研究旨在阐明德里贫民窟贫困人群对登革热的认知与防控实践。
研究材料与方法：本研究于2013年针对3350户家庭开展家庭入户调查。研究按照社会经济地位、住院治疗等健康相关事件的多项变量对受访家庭进行分层。数据收集由25名现场调查员通过面对面访谈完成。
研究结果：约8%的受访家庭至少存在1例确诊登革热病例。与受访人群整体相比，15-19岁青少年与30-34岁成年人的感染率更高，而4岁以下儿童的感染占比偏低。家庭主妇的登革热感染率为24%，高于其在受访人群中的占比（17%）。尽管77%的受访者对蚊虫存在担忧，但仅有43%的受访者会主动监测环境以清除蚊虫滋生地。
研究结论：本研究无法排除以下可能性：尽管4岁以下儿童已接触登革热病毒，但要么其感染为无症状感染，要么同期感染的家庭成员症状更为严重，需住院治疗。该结果可通过该人群受预算限制的健康选择行为得到解释——这类选择并未优先保障幼儿的健康。由于家庭主妇主要负责家庭及周边的储水管理与环境卫生，因此登革热防控教育项目应将其作为核心目标人群，以提升干预效果。即便受访者曾有登革热感染经历，且对登革热风险及其影响因素具备较强认知，但仍缺乏对环境的有效管理。结合“口口相传是受访者获取登革热相关信息的主要渠道”这一现状，市政卫生工作人员应开展上门宣教，向居民普及如何清除蚊虫滋生地、预防登革热感染的相关知识。