RESUMEN
The health belief model (HBM) has been adopted as the principal theory for health education and communication for dengue haemorrhagic fever (DHF) prevention and control in Thailand. The HBM focuses on persuading people to acknowledge their vulnerability and susceptibility to DHF, and the benefits of undertaking dengue larval control in household water containers. This study was undertaken in Khon Kaen province to investigate folk knowledge and beliefs about dengue mosquitoes and larval control campaigns and relating these to the theoretical components of HBM. Findings from this study indicate that health education messages can raise awareness during an outbreak but do not ensure sustained larval control practices. Several barriers are identified, including insufficient control agents, inadequate knowledge of control methods, and incompatibility of control practices with people's beliefs. The barriers prevail over the benefits of recommended larval control practices. In developing health education messages, consideration should go beyond the HBM and focus on control methods that are compatible with the socio-cultural environment in which control practices are being encouraged.
Asunto(s)
Aedes/crecimiento & desarrollo , Virus del Dengue/crecimiento & desarrollo , Dengue/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Insectos Vectores/crecimiento & desarrollo , Control de Mosquitos/métodos , Adolescente , Adulto , Aedes/virología , Animales , Actitud Frente a la Salud , Dengue/transmisión , Femenino , Humanos , Insectos Vectores/virología , Masculino , Población Rural , Tailandia , Población UrbanaRESUMEN
OBJECTIVE: To investigate the influence of larval control methods (using temephos, keeping fish and covering containers with lids), water use and weekly cleaning of containers on the presence of Aedes aegypti larvae in water-storage containers in rural and urban households in Khon Kaen province. METHOD: Cross-sectional questionnaire survey and larval survey covered 966 households and 5821 containers were inspected. RESULT: In rural and urban areas larval control was patchy and often ineffective. Consequently, the mosquito indices exceed the target indices for dengue control with the Breteau Indices of 201 and 113, and Container Indices of 25 and 28 in rural and urban areas, respectively. The containers most frequently infested with larvae were rectangular cement containers storing water for bathing (rural: 37.2%; urban: 35%) and flushing the toilets (rural: 35.7%; urban: 34.3%). Keeping fish [adjusted odds ratio (AOR): 0.08-0.16] was the most effective methods of control. Correctly covering containers with lids was similarly effective (AOR: 0.10-0.25) when used on jars for storing drinking water. However, frequent use of containers reduced the effectiveness of lids. Temephos was effective only in dragon jars in urban areas (AOR: 0.46) where a standard package of temephos were available. Weekly cleaning of containers was an effective method for larval control in most types of containers. A combination of control methods increased effectiveness. CONCLUSION: This study highlights the complex interaction of household water use and larval control practices as well as the importance of determining the most effective control measures compatible with water practices for implementing control promotion.