Exploring the relationships between dengue fever knowledge and Aedes aegypti breeding in St Catherine Parish, Jamaica: a pilot of enhanced low-cost surveillance

Abstract

Purpose

Dengue fever has re-emerged as an increasingly significant global health threat amid diminishing resources pledged for its control in developing nations. Efforts to limit breeding of the dengue vector Aedes aegypti are often hampered by lack of community awareness of the disease.

Methods

Sixty-eight households in St Catherine Parish, Jamaica completed a pilot knowledge, attitude, and practice questionnaire as part of a routine container survey for presence of A. aegypti larvae.

Results

Infestation levels were high according to traditional Stegomyia indices (Breteau index = 325); however, general knowledge of dengue symptoms, A. aegypti breeding sites, and preventive practices was low. After examining the links between demographic characteristics, dengue knowledge, and the number of breeding sites per house, higher educational achievement was associated with higher dengue knowledge, but also with more unprotected containers. Overall dengue knowledge was not associated with household container counts. Spatial statistics identified weak clustering of larvae-positive containers, and larvae were concentrated in three key container types.

Conclusion

Residents may only understand the role of certain container types, and significant gaps in general knowledge of the disease may inhibit vector control. This pilot demonstrates the feasibility of conducting inexpensive, rapid assessment of community knowledge and breeding levels for local governments lacking the resources for a more methodologically robust vector assessment strategy.

Keywords:

• GIS
• community knowledge
• KAP survey

Acknowledgments

The authors acknowledge: The Sparkman Center for Global Health at the University of Alabama, Birmingham, for supporting vector research activities through the Jamaica Field Studies program; Mosquito Control Unit, St Catherine Parish Health Department, for coordinating our field work; Dr Parris Lyew-Ayee and the Mona GeoInformatics Institute for imagery and technical support; Dr Sander Koenraadt for consultation on the KAP instrument; Dr Arthur Getis for spatial statistics assistance; Dr Richard A Nisbett for feedback on a previous draft of this paper; and the residents of Tryall Heights for welcoming our team into their community. Financial support was provided by the Sparkman Center for Global Health at the University of Alabama, Birmingham, and both the Office of International Programs and the College of Health and Human Services at San Diego State University. We thank three anonymous reviewers who helped improve this paper.

Disclosure

The authors report no conflicts of interest in this work.