Health Beliefs and Practices Related to Dengue Fever: A Focus Group Study.

Background: This qualitative study aimed to provide an in-depth understanding of the meaning of dengue fever (DF) amongst people living in a dengue endemic region, dengue prevention and treatment-seeking behaviours. The Health Belief Model was used as a framework to explore and understand dengue prevention behaviours. Methods: A total of 14 focus group discussions were conducted with 84 Malaysian citizens of different socio-demographic backgrounds between 16th December, 2011 and 12th May, 2012. Results: The study revealed that awareness about DF and prevention measures were high. The pathophysiology of dengue especially dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) were rarely known; as a result, it was seen as deadly by some but was also perceived as easily curable by others without a basis of understanding. Young adults and elderly participants had a low perception of susceptibility to DF. In general, the low perceived susceptibility emerged as two themes, namely a perceived natural ability to withstand infection and a low risk of being in contact with the dengue virus vector, Aedes spp. mosquitoes. The barriers to sustained self-prevention against dengue prevention that emerged in focus groups were: i) lack of self-efficacy, ii) lack of perceived benefit, iii) low perceived susceptibility, and iv) unsure perceived susceptibility. Low perceived benefit of continued dengue prevention practices was a result of lack of concerted action against dengue in their neighborhood. Traditional medical practices and home remedies were widely perceived and experienced as efficacious in treating DF. Conclusion: Behavioural change towards attaining sustainability in dengue preventive practices may be enhanced by fostering comprehensive knowledge of dengue and a change in health beliefs. Wide use of unconventional therapy for DF warrants the need to enlighten the public to limit their reliance on unproven alternative treatments. Author Summary: In-depth understanding of health beliefs and behaviors may provide insights into sustainable community-based dengue prevention and control. This study uses qualitative method to explore dengue prevention and treatment-seeking behaviours. Focus group discussions were conducted with Malaysian public of various demographic backgrounds in Klang Valley, Malaysia. General knowledge about dengue fever was good but many lack of knowledge of dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Many had low perceived susceptibility of getting dengue. Barriers to prevent dengue were categorised as low self efficacy to execute preventive measures, perceived lack benefit of individual preventive measures, and unsure susceptibility of getting dengue. Low perceived benefit of continued dengue prevention practices was a result of lack of concerted action against dengue in their neighborhood. Traditional medicinal practices, though unproven, were common and viewed as efficacious. The findings add valuable insights into how health beliefs could affect dengue prevention and control in endemic region. [ABSTRACT FROM AUTHOR]