European Journal of Social Sciences ISSN 1450-2267 Vol. 57 No 1 October, 2018, pp.70-79 http://www.europeanjournalofsocialsciences.com/

Knowledge about Chikungunya: A Case with Private University Students’ of Dhaka, Bangladesh

Sohela Mustari Assistant Professor, Department of Sociology Begum Rokeya University, Rangpur, Bangladesh

Abstract Fever, due to infected Aedesaegypti and Aedesalbopictusmosquitos’ causes’ a serious and emerging public health problem in and around the urban and suburban areas of Bangladesh. Out of many viruses, Chikungunya virus is the most rapidly spreading virus and important for medical health perspectives. With the similar symptoms of Chikungunya, people of urban and suburban areas of Bangladesh are experiencing Dengue virus from last few years. Although Bangladesh experienced few Chikungunya cases in earlier years, butfor the first time in 2017, Chikungunya spread in Bangladesh like epidemic which catches the concern of physicians, researchers and policy makers. This study thus tries to explore the level of knowledge and understanding about Chikungunya virus of private university students of Bangladesh. Both qualitative and quantitative approach is used for this research. A total of 400 samples were interviewed by using convenient sampling procedure to know their knowledge about Chikungunya virus. Similarly, for qualitative data a total of 15 in- depth interviews were conducted with the students. Both experienced and non-experienced students with Chikungunya virus participated in the research.The result shows that 80.6% of the respondents knowChikungunya is a viral disease. The result also shows that 71.4% of the respondents know Chikungunya spreads to humans by the bite of an infected mosquito. However, most of them are not sure about the difference in symptoms of dengue, Chikungunya and other viral fever. So in this research it is suggested to disseminate proper information about Chikungunya through mass media.

Keywords: Chikungunya, Bangladesh, private university, qualitative, quantitative, mass media

Introduction The bite of infected female Aedesaegypti and Aedesalbopictus, mosquitoes transmits a virus to human body which causes high fever with joint pain. This viral fever is primarily known as Chikungunya. These mosquitos usually bite in early morning and late afternoon. These mosquitoes are typically available in and around the urban and suburban areas(Burt et al., 2017). “Chikungunya virus continues to cause large epidemics worldwide, with no specific treatment or vaccine currently available to prevent infection”(Burt et al., 2017). Transmitted from Aedesspp mosquitoes, Chikungunya virus has recently outbreaks in the Indian Ocean and Indian subcontinent. This virus was first identified in Tanzania in 1953 and then spread other African and Asian countries (Mavalankar et al., 2008). “The name chikungunya is derived from a local language of Tanzania meaning "that which bends up" or "stooped walk" because of the incapacitating arthralgia caused by the disease” (Hassan et al. 2014).The first outbreak in Chikungunya occurred in Kenya in 2004 and after that a number of outbreaks occurred throughout the world. Although industrialized and developed 70 European Journal of Social Sciences – Volume 57, Issue 1 October (2018) countries are less affected in Chikungunya Virus but it does not mean that they are free from Chikungunya. However,this virus out-breaks easily in a country where population density is higher(Rezza et al.2007; Bedoya-Arias et al; 2015). This disease has a possibility to be misunderstood that the carrier and symptoms of both Chikungunya and Dengue are same. Assessing knowledge and perception of young generation about epidemiology, symptoms and transmission of Chikungunya virus from different private universities of Dhaka, Bangladesh would be highly relevant, particularly because no information was managed with the young and future generation of Bangladesh. A cross-sectional, explorative study was made with the students of different private universities of Bangladesh. The universities were chosen randomly from the total list of private universities in Bangladesh. A total number of 400 samples were chosen conveniently who gave their consent to answer the provided questionnaire. The students with experience of Chikungunya virus and without experience of Chikungunya virus participated in the interview. A structured questionnaire was used. Students, who agreed to be part of the research, filled out a questionnaire about basic knowledge of the students about the epidemiology, symptoms and prevention of disease. Basic statistics using SPSS v.19 were used to present the statistical data. To incorporate quantitative data with qualitative data, a total fifteen (15) in-depth interviews were conducted as well. In this part, the respondents were from the same population, however; these respondents may join in survey or not, does not considered. In this qualitative part, respondents’ basic knowledge about the epidemiology, symptoms and prevention of disease were collected. These collected data was analyzed with narrative method with traditional method.

Literature Review Chikungunya virus has become one of the emerging public health concerns for Bangladesh. Though Bangladesh is in endemic zone, Chikungunya supposed not be a common disease in Bangladesh (Hassan et al. 2014). However after the Dengue, in 2017 Chikungunya also demands much attention for its outbreak nature. The first outbreak of Chikungunya feverwas reported as “Dhaka fever” in 1964(Mortayez et al., 1997). Later on, Bangladesh witnessed Chikungunya outbreak in 2008 and from then report of Chikungunya comes in regular basis (Hassan et al. 2014). However in 2017 it came as an epidemic nature.In Bangladesh, Chikungunya outbreaks reported mostly in urban based areas. A recent research claimed that Bangladeshi adult women, who stay most of their day time in their own house, experienced the highest attacks with Chikungunya virus(Khatun et al, 2015). Sometimes Chikungunya comes with no symptom. Person cannot make difference Chikungunya fever from other fever. Similarly, the symptoms of Chikungunya sometimes overlap with Dengue like fever and pain. However, in general, Chikungunya comes with high fever along with headache, fatigue nausea, vomiting, rash and joint pain. It is also not uncommon that patients may have gastrological problem. Physicians claimed that there are no anti-viral drugs for Chikungunya. Physicians usually provide to the patient of Chikugunya paracetamoles and avoid Aspirin group medicine. For general cases, physicians recommend staying in house and if necessary to reduce the joint pain, patient can take the therapy. Finally according to the physicians of Bangladesh, though Chikungunya causes serious sufferings but there is nothing to be worried for death. As there is no vaccine for this disease, it is recommended to spread knowledge and increase awareness among the citizens (Azad, 2013). So far of the knowledge of the current researcher, there is no paper concerning on knowledge of Bangladeshi on Chikungunya in general, and knowledge of private university students in specific. However, it is notified that few related works by international researchers of other countries have been done. A research in a coastal district of Karnataka state of India in 2008 claimed that 70% respondents of their research knew that Chikungunya spreads through the bites of mosquito but only 20% of them were knowledgeable that this spreads from Aedes mosquitoes (Majra& Acharya, 2011). The same study also claimed that people who had knowledge about the symptoms and preventive of the disease

71 European Journal of Social Sciences – Volume 57, Issue 1 October (2018) are less likely to be affected by chikungunya (Majra & Acharya, 2011). In a systematic review paper, it is claimed that Knowledge and perception of Chikungunya among the public and health professions varies country to country and those countries which have experience of Chikungunya are more knowledgeable than the others (Corrin et al., 2017). Finally getting the gap in existing literatures, this article intends to know the level of knowledge of the private university students about Chikungunya virus, symptoms and prevention of disease.

Methods This section is divided into five sub-sections which are target groups, time and location of survey and in-depth interviews, sampling techniques, data collection and data analysis techniques.

Target Group Only private university students of Dhaka and nearby areas, who are currently active students in both under-graduate and post graduate levels, are considered as the target group for this study.

Time and Location of Survey and in-Depth Interviews The severity of outbreaks of Chikungunya was April 1, 2017, to Sept 7, 2017 (Kabir et al; 2017). This research thus, started to work after epidemic reduced its severity from September 2017 . A survey was conducted with the private university students from September 2017 to December 2017. Similarly, during the same time in-depth interviews were carried out with the same target groups.

Sampling Techniques A comprehensive list of the Private universities was collected. From this list name of Private universities was selected using simple random sampling (SRS) techniques. A total 17 private universities name were taken randomly; the universities are: , BRAC University, , Southeast University, Daffodil University, American International University Bangladesh (AIUB), University of Liberal Arts Bangladesh (ULAB), Northern University, Southasia University, Independent University, Bangladesh (IUB), International University of Business Agriculture and Technology(IUBAT), Royal University, BGMEA University of Fashions and Technology, University of Information Technology and Sciences (UITS),Asia Pacific University, ,Primeasia University. Finally from these universities 400 samples were selected conveniently based on their availability and interest to participate in the survey. From the same population, a total of 15 respondents were selected for in-depth interviews. Some of them already participated in survey and some of them only participated in in-depth interviews. Similar to survey, here some (10 respondents) of the respondents had experience of Chikungunya virus and some (5 respondents) had no experience of having Chikungunya virus yet.

Data Collection A structured questionnaire was administered to the students that collected primary data to know their socio-economic profile, knowledge about Chikungunya and their experience of having Chikungunya. Likewise a checklist was prepared to carry out the in-depth interviews. The checklist contained questions to know their socio-economic profile, knowledge about Chikungunya and their experience of having Chikungunya.

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Techniques of Data Analysis Both Quantitative and qualitative methods were used to analyze the collected data. Descriptive (frequency and percentage) analysis was used to describe the socio-economic characteristics and the knowledge about Chikungunya of the respondents quantitatively. However narrative analysis procedure was used to describe the socio-economic characteristics, the knowledge and experience about Chikungunya of the respondents qualitatively.

Results

Table 1: Socio-economic information of therespondents of the survey, 2017

Items Frequency (n) Percentage (%) Level of study Undergraduate 391 97.75 Postgraduate 9 2.25 Age Below 18 years 09 2.25 18-26 years 387 96.75 Above 26 years 4 1 Gender Male 271 67.75 Female 129 32.25 Current residential area Dhaka North 251 62.75 Dhaka South 149 37.25 Did you experience Chikungunia virus Yes 147 36.75 No 253 63.25 Source: Survey, 2017

Most of the private universities of Bangladesh are heavily dependent on under graduate level of studies. The result of this study reflects that 97.75% of the respondents are currently engaged in under graduate level of study. The result shows that 96.75% of the respondents are within the age range of 18 to 26 years. The study also confirms that majority (62.75%) of the respondents current residential area is in Dhaka North. In demographic section, this research also attempts to know the percentage of Chikungunya affected respondents. The study shows that 36.75% of the respondents already affected by Chikungunya. This number is truly huge and threat for public health.

Table 2: General knowledge of the respondents about Chikungunya

Items Frequency and percentage Agree= 328 (82%) Chikungunya is a viral disease Neutral= 51 (12.75%) Disagree=21 (5.25%) Agree= 366 (91.5%) Chikungunya causes fever Neutral= 25 (6.25%) Disagree= 9 (2.25%) Agree= 293 (73.25%) It is spread to humans by the bite of an infected mosquito Neutral= 89 (22.25%) Disagree= 18(4.5%) Agree= 211 (52.75%) Aedesaegypti mosquitoes spread or pass on the chikungunya virus Neutral=166 (41.5%) Disagree= 23 (5.75%) Agree= 321(80.25%) The most common symptoms of chikungunya is severe joint pains Neutral=56(14%) Disagree= 23 (5.75%) 73 European Journal of Social Sciences – Volume 57, Issue 1 October (2018)

Items Frequency and percentage Agree= 126 (31.5%) Prolonged effects of chikungunya include arthritis Not sure = 242 (60.5%) Disagree= 32 (8%) Agree= 128 (32%) Prolonged effects many cause disabling to people Not sure =227(56.75%) Disagree= 45 (11.25%) Agree= 189 (47.25%) Symptoms of chikunguniya can last for months to even years Not sure =149 (37.25%) Disagree= 62 (15.5%) Agree= 252 (63%) Other symptom of chikungunya include headache Not sure =112(28%) Disagree= 36(9%) Agree= 199(49.75%) Others symptom of chikungunya include backache Not sure = 164(41%) Disagree= 37 (9.25%) Agree= 193 (48.25%) New borns are at high risk of chikungunya Not sure = 175(43.75%) Disagree= 32 (8%) Agree= 176 (44%) Elderly are at high risk of chikungunya Not sure = 172(43%) Disagree= 52 (13%) Agree= 157 (39.25%) Affected women can high risk of diseases for the new born baby Not sure = 214 (53.5%) Disagree= 30 (7.5%) Source: Survey, 2017

This section was asked to all the respondents regardless of their experience of having Chikungunya virus. A secondary source confirms that Edes mosquitoes are the primary vector for Chikungunya. However only half (52.75%) of the respondents know about this. Although 91.5% of the respondents agree that Chikungunya causes fever but many of them disagree that this fever is a viral disease (5.25%). The objective this part was to know their knowledge. As the common symptom of Chikungunya, the respondents mentioned about severe joint pains (80.25%), headache (63%), and backache (49.75%). Among all these respondents, 47.25% of the respondents concur that Symptoms of chikunguniya can last for months to even years. To explain the symptoms of Chikungunya, the respondents of in-depth interviews included fever, joint pains, dizziness, rash and weakness. They shared the nature of acuteness of Chikungunya. They said that with Chikungunya it was difficult for them to sit in chair, to walk for few steps or even to lie down. Participant A (female, 25, Experienced with Chikungunya): “I woke up from sleep and I felt pain in my joints of right hand. It was a feeling like paralyzed. I was thinking, am I going to die!! Why the pain is like this!!” Participants of in-depth interviews had diversified experience with the Chikungunya symptoms. Some had perceived long-term complaints and the other had very short term sufferings like other general fevers. However, some other uttered that they had experienced a second phase of their sufferings once their temperature had gone. These second phases of sufferings are mostly because of their long lasting joint pains. Participant B (male, 25, Experienced with Chikungunya): “I suffered with high fever only for 3 days. Now it’s almost two months after the fever had gone but still I cannot walk properly. I cannot step my feet in regular rhythm. I am scared whether I can get back my previous normal life or not!!” The reasons of diversified knowledge about Chikungunya were discovered from respondents with no experience of having Chikungunya. The campaign of Chikungunya through media and other agents was not sufficient in a regular basis. Participant 1(Male, 22, no experience with Chikungunya): “I did not

74 European Journal of Social Sciences – Volume 57, Issue 1 October (2018) get Chikungunya yet. I never heard this fever’s name before. After the epidemic of this year, for the first time, I noticed this fever from newspaper. I am seriously scared of it!!” It is believed that as aedes mosquito stays in watery and dumps places where the young kids may visit and caught by it easily. Moreover, common people also think that older people suffer more in it as they have weaker physical ability. Contrarily, common people also believed that young people with good physical ability suffer less as they have good immune capacity. However in reality even the young people within the age range of 20 to 40 years also found with tough emotional condition at that time. Participant F (female, 28, Experienced with Chikungunya): “I was not afraid with the pain at the beginning; I thought I can handle it. But “no”, it was so severe that I cannot even keep my body in the chair. I went to the doctor. With the medicine, the fever went away but the pain is still present. I heard this pain will never go back. I am very much frustrated ”. Participant 2(Female, 23, no experience with Chikungunya): “Media is saying, there is no medicine of Chikungunya and I saw many of my friends to suffer from it with high fever and severe joint pains. I am not sure what is waiting in their life. I am scared with the situation” Limited knowledge about transmission of virus was also found in this research. Some of the respondents and their friends and family believed that Chikungunya virus can be transferred to others if a mosquito bite the infected person and then bite a person with normal health condition. Participant I (23, male, Experienced with Chikungunya): “My eldersister with her two young kids was invited in our house. But she refused to come on that day as she knew I was infected with Chikungunya virus. At that time I was not sure about the transmission process of Chikungunya virus, so whole day and night of three (3) long days, I stayed inside the mosquito net so that no other members can be infected. ” Participant 3 (male, 25, no experience with Chikungunya): “Some days before media talked about zika virus which can be transferred to other persons from an infected person. Now the same media is saying Chikungunya is not transferable to other persons. Now we cannot keep full trust to media as both viruses originate from infected mosquitoes. I am seriously confused and worried”.

Table 3: GeneralOpinionsabout Chikungunya

Item % Agree= 218 (52.75%) There is no medicine for chikungunya Not sure = 94 (23.5%) Disagree= 88 (22%) Agree= 220 (55%) There is no vaccine for chikungunya Not sure = 118 (29.5%) Disagree= 62 (15.5%) Agree= 252 (63%) Only paracetamol is the suggested medicine for chikungunya Not sure = 110(27.5%) Disagree= 38(9.5%) Agree= 148 (37%) Pain killer can be taken during chikungunya Not sure = 149 (37.25%) Disagree= 103 (25.75%) Agree= 206 (51.5%) Symptom of chikungunya is different from dengue Not sure =152(38%) Disagree= 42 (10.5%) Agree= 145 (36.25%) Wearing light colored cloth is suggested to avoid mosquito bite Not sure = 189 (47.25%) Disagree= 66(16.5%) Source: survey, 2017

This section was for all respondents regardless they were affected by Chikungunya virus or not. At the beginning of this section they were asked whether there is any medicine to recover from Chikungunya or not. It is found that more than half (52.5%) of the sample agreed that there is no medicine yet forCikungunya virus. So very rationally the findings showed that more than 60% of the 75 European Journal of Social Sciences – Volume 57, Issue 1 October (2018) respondents think ‘paracetamol” could be the only medication for Chikungunya virus. Though a number of respondents claimed that Chikungunya causes joint pains but many of them (35.3%) are not sure about taking pain killer as a remedy from it. Dengue is another common fever in Bangladesh. So very rationally the respondents were asked whether the symptom of Chikungunya are as same of Dengue fever or not. As the respondents did not have enough knowledge about Chikungunya, 36.1% of them are not sure about the difference in symptoms of Chikungunya and Dengue. As many respondents were not knowledgeable and aware about Chikungunya virus, during and after the onset days, many respondents were found with stressed, anxiety, confused, frustrated and feeling left out. This emotional stressed was absolutely due to their low level of knowledge about Chikungunya virus. They were not informed much about the symptoms and severity of Chikungunya virus. This low level of knowledge pushed the participants to think that they may face death or life long paralysis with this virus. Participant A (female, 25, Experienced with Chikungunya): “I was thinking, I am going to die. I was overwhelmed with the sudden situation .” Participant E (male, 24,Experienced with Chikungunya): “ I prayed to God, please do not give this sufferings even to my enemy !!” Participant C (female, 27, Experienced with Chikungunya): “I felt shy to my mother for taking help in every simple work. I thought, may be whole life I have to continue with this ”. Participant 5 (male, 24, no experience with Chikungunya): “At the beginning, with the scream of my friend (infected friend), I thought maybe it is a serious issue. He may die!! So without doing late, I called his family to come. I was not well informed at that time about Chikungunya virus”.

Table 4: Information about the experience of Chikungunya virus

Last Week= 4 (1.0%) One Week Before=12 (3%) Two Weeks Before= 26 (6.5%) Three Weeks Before= 39 (9.7%) Please mention the approximate data of onset symptom One Month Before= 23 (5.7%) of chikungunya virus One and Half Month Before= 18 (4.5%) Around Two Month Before= 12 (3%) Three Months Before= 4(1%) More than three months before= 2 (0.5%) Yes at a public hospital= 17 (4.2%) Yes at a private hospital= 49 (12.2%) Did you visit a health care provider due to symptoms Yes at a private doctors chamber= 46 (11.4%) Yes at university healthcare centre= 4 (1%) I did not see any healthcare provider= 27 (6.7%) 0 day= 6 (1.5%) 1 to 3 days= 21 (5.2%) Days of university missed due to chikungunya virus 4 to 6 days= 23 (5.7%) 7 to 9 days= 45 (1.2%) More than 10 days= 47 (11.7%) Fever= 41 (10.2%) Headache= 31 (7.7%) Dizziness= 27 (6.7%) Stiff neck= 15 (3.7%) Symptoms experienced Breathing difficulty= 10 (2.5%) Muscle pain= 2 (0.5%) Muscle weakness= 9 (2.2%) Diahorea= 5 (1.2%) 12= 1 (0.2%) Yes= 74 (18.4%) After recovering did the symptom reappear No= 64= (15.9%) Yes= 57 (14.2%) Prior to chikungunya did you use a mosquito net every Never= 30 (7.5%) night Sometimes= 48 (11.9%) 76 European Journal of Social Sciences – Volume 57, Issue 1 October (2018)

Yes= 72 (17.9%) Do you have standing still water close to your home No= 66 (16.4%) Radio= 12 (3%) Television= 41 (10.2%) Newspaper= 36 (9%) If you were informed about chikungunya virus Posters= 2(.5%) Doctors= 10 (2.5%) Others= 30 (7.5%) Source: survey, 2017

The above information is collected from those who suffered Chikungunya in 2017. In the above section, it is found that after getting symptoms of Chikungunya, respondents mostly rely on private doctors (around 24%) as their health care providers, either in private hospitals or in their private chambers. Though the respondents are students of various universities but only 1% of them visited their own university health centre to get health care services. Moreover, due to Chikungunya virus, 11.7% students had to miss their university classes for more than 10 days. During those days of Chikungunya, students suffer from number of different symptom where the most common (10.2%) symptom was fever. Along with fever, headache (7.7%) and dizziness (6.7%) were another two common symptoms during those days of Chikungunya. A matter of attention is that around 19% students who suffered from Chikungunyaaffirm that the symptoms of Chikungunya reappear and continues even after Chikungunya went away. The students were asked whether they used mosquito nets prior to Chikungunya or not. Though 14.2% of the students assures that they used to use mosquito nets regularly but a good number (7.5%) of students were not habituated in using mosquito nets ever. Secondary sources stated that standing water in nearby areas of urban areas of developing countries is good source of mosquitoes with Chikungunya virus. To justify this issue, students were asked whether they found standing water log in their nearby areas or not. Though 72 students affirms that water logging are quite common in their nearby areas but 66 students denied the issue. To explain the sufferings, almost all the respondents said the same things in their in-depth interviews. All of them suffered with severe pain in such a way that from their onset day of sufferings they fail to walk, to hold anything and to do regular activities. Participant C (female, 27, Experienced with Chikungunya): “I live in my house only with my mother. He is 58 years old and I am used to help her in all her works. But during the Chikungunya days, I was unable even to hold my glass to drink water. My mother helped me at that time. Sometimes I felt so shy for it!!” Participant D (female,20, Experienced with Chikungunya): “I did not understand its severity at the beginning. Though I was feeling severe pain in my knees, I did not care. But when I start to step out from the bed to the toilet, I fall down on the floor. I was not sure what was going on with me!!” Lack of proper knowledge about Chikungunya caused social life problem for many respondents. For many respondents, long duration and severity of Chikungunya caused inabilities to joint and perform regular activities. This caused hamper in social life for many of the respondents. However, this was not true for all respondents. Participant G (male, 22, Experienced with Chikungunya): “I have missed my regular classes of two weeks. During that time, I have missed my quiz and presentation as well. When I rejoin my classes and request my teacher to consider my classes, presentation and quiz, she smiled at me as if Chikungunya was an excuse from my side. I felt so humiliated !!” Participant H (22, female, Experienced with Chikungunya): “ I was caught by Chikungunya before my semester final examination. So I decided to continue my classes, though I had severe pain in all my joints. I took one of friends (male) help to walk. I looked at others and saw their faces which said negative words about my dependency on my friends. Later I failed to continue my classes .” Participant 4 (male, 22, no experience with Chikungunya): “I stay with my friends in a students’ mess (hostel). Two of my friends are already infected with Chikungunya virus. They could not do their regular works with their own and suffered from fever with severe pain. They missed number of their 77 European Journal of Social Sciences – Volume 57, Issue 1 October (2018) classes and quiz. Not only were they, to take care of them, I along with other members of the mess also needed to miss our classes. This caused negative impact on our CGPA”. Limited knowledge was found in getting treatment as well. The common treatment during the Chikungunya days was to stay at home and take rest because most of the respondents did not understand what was going on with them. Once they recovered from fever and joint pains and other symptoms continued, many of them visited the physician. However, others are found not to visit any physician as they believed there was no proper treatment and medication yet for the patients. So it was a better decision for them to stay at home and taking care from friends and family.

Discussion Chikungunya is one of the emerging public health concerns for the society. The lack of proper knowledge and awareness about Chikungunya causes socio-psychological impact on the patients and their friends and families. The severity of its temperature, joint pains and other symptoms of Chikungunya and along with all these the long-term sufferings cause major socio-economic impacts on the society. Existing literature of Moro et al., (2012) showed that in Italy, 66.5% of the respondents are getting sign and symptoms of Chikungunya even after 12 months. Similarly, in this research it is found that some respondents are suffering with the aftermath of Chikungunya even after months. Moreover, in this current research it is found from number of respondentsthat due to lack of knowledge, they are confusedabout the disease. They are not confirmed whether this fever is general fever, dengue or any other disease. This issue should be considered carefully as this is clear indication of their lack of knowledge and awareness about Chikungunya virus. It is important to provide information about Chikungunya on time and media, health care providers, government and non- government organizations should work together and proactively to disseminate the message on the Chikungunya. The lack of knowledge and spread of Chikungunya virus has negative impact on respondents’ financial capacity as well. Like existing literature (e.g; Cardona-Ospina et al., 2015), this current research also found financial charge of Chikungunya on the respondents. Both the quantitative and qualitative data showed that respondents visited mostly private hospitals and private doctors to get health care support during and after the crisis period. Moreover respondents were needed to stay at their home without continuing their class, quiz and examinations which has definite negative impacts on their results and in many cases they may need to count extra money for their tuition fees. Another shocking issue has come out from this research. The lack of knowledge was found when many respondents narrated that Chikungunya is a transferrable disease and with this excuse they preferred to keep the infected person aside in a room. Creating awareness and knowledge about Chikungunya is a must issue to come out from this social barrier.

Conclusion Chikungunya caused social burden for the private university students by giving them pressures socially, psychologically, economically. It causes burden not only for the infected persons rather for his/her friends and family also. This research thus suggests the authority to disseminate knowledge about Chikungunya in a regular basis so that members of society can be aware from it. This research also suggests the researchers and policy makers to conduct more research from diverse perspectives as this current research has focused only on private university students due to its resource limitations.

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