It is crucial to assess local communities on their knowledge, attitude and practice (KAP) towards dengue prevention practices so as to achieve an effective health intervention. The most powerful prevention strategy is through health education and community participation. In order to combat the escalation of dengue in Malaysia considerable measures have been undertaken to prevent or limit the risk factors of infection among the population. Patterns of dengue transmission in Sabah are associated with a rapid rate of urbanization in close proximity to disturbed forest environments, thereby providing a risk of spill-over of sylvatic pathogens to human populations. According to current national statistics on dengue, Sabah, located in East Malaysia on the northern portion of Borneo, recorded a cumulative 3615 dengue cases between December 2019 and June 2020, making it the state with the fourth highest incidence, ranking only behind the more developed states of Kuala Lumpur, Selangor and Johor. The incidence of dengue varies between the 13 states and three federal territories that comprise Malaysia due to several associated risk factors. The largest ever outbreak was reported in 2014, with 108,698 confirmed cases, which equated to an incidence rate of 361 per 100,000, and 215 deaths. In this country of 32 million people there has been a recent steep rise in the number of dengue cases reported annually, from 46,171 in 2010 to 83,849 in 2017. This includes the Southeast Asian nation of Malaysia that occupies parts of the Malay Peninsula and the island of Borneo. The KAP items retained in the final version of the survey were reliable and valid to be use as a questionnaire reference when conducting future similar studies among the population of Sabah.ĭengue, a mosquito-borne viral disease of humans, is becoming a major global public health concern and socioeconomic burden, especially in tropical and subtropical countries because of the increasingly high incidence of infection. The communalities of the practice section showed that seven items had low h2 values (< 0.3), which were therefore excluded from further analysis, and only 11 items were retained. In terms of discrimination, 65.9% (29/44) of items were within or close to the acceptable range of 0.35 to 2.5, and 24 items (54.5%) failed to fit the 2-PL IRT model (P 0.7, while based on the communalities, 11 items in the attitude section were excluded due to very low h2, factor loading values and low correlation with the total ( 0.7. Resultsįor the knowledge section, only 70.5% (31/44) of items were within or close to the parameter acceptable range of −3 to + 3 of difficulty. The construct validity and reliability of items for sections on attitude, practice and treatment-seeking behaviour were analysed using psy package. The knowledge section was analysed by two-parameter logistic item response theory (2-PL IRT) using ltm package. Data analysis was performed using SPSS and R software in the R Studio environment. Information on the socio-demographic characteristics of the participants (six items), their KAP (44, 15 and 18 items on knowledge, attitude and practice, respectively) and treatment-seeking behaviour (five items) towards dengue was collected using a structured questionnaire. MethodsĪ community-based cross-sectional study was conducted from October 2019 to February 2020 involving 468 respondents. In this study we aimed to assess and develop a reliable and valid KAP survey on the subject of dengue that is suitable for the resident population of Sabah, Malaysia. Several studies have reported a significant association of knowledge, attitude and preventive practice (KAP) regarding dengue infection among community’s resident in endemic areas.
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