Journal of Xi'an University of Architecture & Technology ISSN No : 1006-7930 USE OF THE HEALTH BELIEF MODEL FOR THE ASSESSMENT OF PUBLIC KNOWLEDGE AND HOUSEHOLD PREVENTIVE PRACTICES IN DHAKA, BANGLADESH, A DENGUE-ENDEMIC CITY Tanvir Abir, PhD (1) Associate Professor, College of Business Administration, International University of Business Agriculture and Technology, Dhaka -1230, Bangladesh. Professor Nazmul Ahsan Kalimullah, PhD (2) Vice-Chancellor, Begum Rokeya University, Rangpur. Rangpur- 5404, Bangladesh. Taha Husain (3) Lecturer, Department of Gender and Development Studies, Begum Rokeya University, Rangpur. Rangpur- 5404, Bangladesh. Dewan Muhammad Nur -A Yazdani (4) (* Corresponding Author) Assistant Professor, College of Business Administration - CBA International University of Business Agriculture and Technology—IUBAT University, Dhaka -1230, Bangladesh. Abu Taher Md Sanaullah Nury (5) Deputy Director (MIS-Dev), Management Information System Unit, Directorate General of Family Planning, Ministry of Health and Family Welfare, Bangladesh. Kazi Fayzus Salahin (6) Senior Executive, Research, SRGB Research & Consulting Limited. Kingsley Agho, PhD (7) Senior Lecturer, School of Science and Health, Western Sydney University, Australia. Abstract Prevention is the most efficient way to get rid of any pandemic; it is no exception to Dengue Fever (DF). Assessment of public knowledge and health credentials is critical for designing strategies for any disease prevention. This study aims to explore awareness, health perceptions and preventative measures of Dengue Fever (DF) in various social and economic segments in Dhaka, Bangladesh. A cross-sectional questionnaire survey of 242 respondents attending the dengue awareness events was conducted. The information on socio- demographic characteristics of the participants and their knowledge, attitude and practice on dengue fever was collected. The findings of this study revealed that there is no doubt among the 76.4% (n=185) participants that Ades Mosquito is mainly responsible for Dengue. The majority 97.5% (n=236) of the respondent believe that dengue is becoming a serious health 1 Volume XII, Issue IV, 2020 Page No: 2800 Journal of Xi'an University of Architecture & Technology ISSN No : 1006-7930 problem in this region. The causes of dengue in this region are water mismanagement (39.7%), water clogged (33.9%), poor drainage system (18.2 %). This study found different responses associated with the characteristic of insect and 99.2% of the respondents have not enough knowledge about dengue and Aedes mosquito. Also, the respondents have not shown enough attitude and awareness (96.3%) to dengue, and most of the respondents have moderate level (72.3%) prevention practices on dengue fever (DF). Finally, this study concluded that the Health Belief Model does not work in Bangladesh. Keywords: Dengue, Public Knowledge, Preventive Practice, Bangladesh, Hemargic Fever, Public Awareness Introduction Dengue is a mosquito-borne1 disease which is caused by Aedes aegypti's2 bite (Kumar and R. Kumar, 2013). While dengue is an ancient disease, Chinese medical records incorporated the first indication of the disease. Accordingly, the disease was first identified in 992 AD in China. However, some researchers claim the illness mentioned in China's Xin monarchy documents (265-420 BC) was described as a poisonous water disease' caused by flying insects (Bostan et al., 2016). Among the places where dengue mosquitoes and viruses are found in South Asia, the Caribbean, the Indian subcontinent, South and Central America, Africa, the Pacific Islands and Australia. In the Philippines and Thailand, around 1950s dengue was first diagnosed as an outbreak. The outbreak of Dengue Fever (DF) had only been seen in nine countries before 1970. But now, in more than 100 countries3, dengue fever (DF) is being seen. The disease has widespread in the last 25 years of the 20th century (Prasittisuk et al., 1998; Kuno, 2009). In South America and Asia Dengue is more prevalent than anywhere else in the world. In 2019 alone, 1.6 million people were infected with the mosquito-transmitted disease in South America. The prevalence of dengue is extreme in most countries in Southeast Asia, countries such as the Philippines, Sri Lanka, Malaysia, Cambodia, Laos, Vietnam and Thailand are work victim of dengue epidemic. As the amount of Aedes mosquito permeates, the number of patients suffering from dengue is growing. Nearly 40% of the world's total population is at risk for dengue (Villar et al., 2015). The disease has grown as much as 30 times in the last 50 years. As a result of this rapid expansion, this disease affects about 100 million people in the world's tropical areas. Because of this disease, 20000 people die in a year alone and about 25 people per minute (WHO, 2012a). Other than those urbanizations and polluted climates, the climate change such as temperature rise, constant rainfall and travel from one continent to another continent is increasing the prevalence of dengue fever (DF) (Karim, Munshi, Anwar, and Alam, 2012). Rachel Lowe, an assistant professor at the London School of Medicine and Hygiene, says the warmer climate has created a favorable environment for dengue outbreaks through virus reproduction and mosquito breeding (Prothom-Alo, August 9, 2019). Thus, the dengue fever (DF) and dengue mosquito have taken a dire shape for everyone. About six billion people will be at risk of getting dengue fever (DF) by 2080 (Messina et al., 2019). 1 An Arboviral infection 2 A type of vector mosquito or insect 3 Every year, 1 million dengue cases are diagnosed in 125 countries, and about 10000 deaths are reported (Messina et al., 2019). 2 Volume XII, Issue IV, 2020 Page No: 2801 Journal of Xi'an University of Architecture & Technology ISSN No : 1006-7930 Bangladesh as a subtropical country has nearly all the specific weather conditions that enable the Aedes aegypti and Aedes albopictus to thrive. Dengue is affecting more and more people in the country because of this urbanization, climate change and demographic factors (Chowdhury, 2019; Lam, 1993). This epidemic of the disease has been in the country for the last two decades (IEDCR, 2019). In previous years, Dengue area included only several of the country's divisional cities but recently patients with dengue were found in remote areas of the country4 as well. The number of people affected doubled in 2019 relative to the statistic from 2018 and in the same year 107 deaths attributed to dengue (The Daily Star, 2019; IEDCR, 2019). The prevalence of dengue fever (DF) in Bangladesh is generally high due to the monsoon season from July through October (WHO, 2019). During this time the drain, floral tub, barrel and plastic containers filled with stagnant water, which is conducive for mosquitoes to lay the eggs on it. The Disease Control Division of the Department of Health, the Ministry of Local Government, the City Corporation and the Pesticides Department of the Municipality of Bangladesh work in mosquito control during this time (Islam, 2019). Yet failure to kill mosquitoes and lack of effective anti-mosquito medicines in cities shows that Bangladesh is far behind in dengue disease control (Morol, 2019). In such a situation this study aims to examine the triggers and solutions of Bangladesh's dengue epidemic. Literature review The studies that have been done on Dengue have highlighted the causes of Dengue prevalence, the effects of Dengue and the ways to prevent dengue. In Australia's case, Russell et al., (2009) studied the possible impact of climate change on dengue spread in Australia. According to them, dengue outbreaks are currently limited to Queensland, Australia, but with rising temperatures, Aedes mosquitoes are likely to rise significantly in some Australian regions. Important factors for the future spread of dengue and vectors are increased reproduction of dengue mosquitoes in Asian and Pacific countries, and transmission of viruses from Asian and Pacific countries. In his study, Gubler (2011) contended that half of the world's population lives in areas at risk of dengue. During the past 40 years, the dengue epidemic has increased dramatically. Several factors are responsible for this increased outbreak but the significant ones are urbanization, globalization and lack of mosquito control. The cities have modern airports through which millions of travellers fly each year, but the mosquito control system is not successful. As a result, the virus spreads from one area to another and the dengue takes on the appearance of an epidemic. Wu et al., (2009) explain dengue incidence in Taiwan as a result of high temperatures and urbanization. Their work investigates how dengue mosquitoes can be affected by temperature and other environmental factors. They presented dengue mosquito spatial patterns in 356 cities using the Geographic Information System (GIS) and found that the dengue risk increases when urbanization is high and the average monthly temperature is greater than 18 4 According to data from DGHS (2019), 87,953 people were infected with Dengue in the country from 1 January to 30 September 2019, of whom 57,166 were in the Dhaka Division, 6740 in the Chittagong Division, 9009 in the Khulna Division, 5704 in the Barisal Division, 4724 in the Rajshahi Division, 953 in the Sylhet Division and 2143 in the Mymensingh Division. 3 Volume XII, Issue IV, 2020 Page No: 2802 Journal of Xi'an University of Architecture & Technology ISSN No : 1006-7930 degrees Celsius. The monthly average 1-degree Celsius rise in temperature increases the risk of dengue infection by 1.95 times. Harving and Rönsholt (2007) reflect on the family-level economic impact of dengue hemorrhagic fever. For their study, they included 155 children aged 0-15 in South Vietnam. Parents or guardians of children who were hospitalized for 10 weeks were interviewed to determine the cost of care for their child. The study found that the average (direct and indirect) family expenditure on treating a child in South Vietnam is around $61. Hospitalization costs are reduced parental income which creates an economic burden on a family.