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Dengue Vector Control through Community Empowerment: Lessons Learned from a Community-Based Study in Yogyakarta, Indonesia
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Department of Public Health, Universitas Ahmad Dahlan, Yogyakarta 55164, Indonesia.ORCID iD: 0000-0002-7299-0360
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2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 6, article id E1013Article in journal (Refereed) Published
Abstract [en]

Effort to control dengue transmission requires community participation to ensure its sustainability. We carried out a knowledge attitude and practice (KAP) survey of dengue prevention to inform the design of a vector control intervention. A cross-sectional survey was conducted in June⁻August 2014 among 521 households in two villages of Yogyakarta, Indonesia. Demographic characteristics and KAP questions were asked using a self-managed questionnaire. Knowledge, attitudes and practice scores were summarized for the population according to sex, age, occupation and education. The average knowledge score was rather poor-3.7 out of 8-although both attitude and practice scores were good: 25.5 out of 32 and 9.2 out of 11 respectively. The best knowledge within the different groups were found among women, the age group 30⁻44 years, people with a university degree and government employees. Best practice scores were found among retired people and housewives. There were several significant gaps in knowledge with respect to basic dengue symptoms, preventive practices and biting and breeding habits of the Aedes mosquito. In contrast, people's practices were considered good, although many respondents failed to recognize outdoor containers as mosquito breeding sites. Accordingly, we developed a vector control card to support people's container cleaning practices. The card was assessed for eight consecutive weeks in 2015, with pre-post larvae positive houses and containers as primary outcome measures. The use of control cards reached a low engagement of the community. Despite ongoing campaigns aiming to engage the community in dengue prevention, knowledge levels were meagre and adherence to taught routines poor in many societal groups. To increase motivation levels, bottom-up strategies are needed to involve all community members in dengue control, not only those that already comply with best practices.

Place, publisher, year, edition, pages
MDPI, 2019. Vol. 16, no 6, article id E1013
Keywords [en]
community participation, dengue, empowerment, vector control
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:umu:diva-157667DOI: 10.3390/ijerph16061013ISI: 000465159500113PubMedID: 30897770Scopus ID: 2-s2.0-85063615135OAI: oai:DiVA.org:umu-157667DiVA, id: diva2:1300121
Available from: 2019-03-28 Created: 2019-03-28 Last updated: 2026-05-29Bibliographically approved
In thesis
1. Dengue Prevention and Control in Indonesia: a case study in Yogyakarta City
Open this publication in new window or tab >>Dengue Prevention and Control in Indonesia: a case study in Yogyakarta City
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Integrated efforts that involve many public health sectors are required to combatdengue in any setting. Hospitals are responsible for providing accurate diagnosis and reportingconfirmed dengue cases to the health authorities, which serves as an alarm for increasingpreventive measures. Community participation in dengue vector control is essential becauseit affects sustainability and cost-effectiveness of preventive and control. This thesis aimed toprovide an in-depth understanding of dengue prevention and control in Yogyakarta, Indonesia,in order to contribute to strengthening the country’s health system and the implementation ofstandardized and well-accepted dengue control strategies. Several aspects have been studiedin term of dengue prevention and control (case management and reporting, surveillance andvector control) in a dengue-endemic region of Indonesia – namely, Yogyakarta.

Methods: This thesis comprises four individual research studies: Knowledge, Attitude andPractice (KAP) survey, control card intervention, implementation of the Jumantik programmeand dengue case management and reporting in hospital. A descriptive analysis, followed by apre-post assessment, was performed in the community. A mixed-method approach was usedfor assessing the Jumantik programme and qualitative approach was conducted for the hospitalstudy.

Results: The findings indicated that: (i) KAP regarding dengue vector control were sufficient butcertain aspects still had weaknesses; (ii) level of community participation in vector control wasnot satisfactory for several reasons, including lacking time, being busy with work and memberof the community feel that vector control was not their responsibility; (iii) the Jumantikprogramme dealt with various obstacles, especially those related to public acceptance; (iv)coordination between the district health office and hospitals for early dengue detection didnot run optimally. We also found that standard operating procedures for dengue managementdiffered between hospitals.

Conclusions: The results clearly show that dengue prevention and control efforts in Yogyakartaface certain challenges that must be addressed. While many World Health Organizationrecommendations are being followed, the weaknesses found in some aspects of theimplementation, as well as the lack of integration for various dengue prevention and controlelements, need to be promptly addressed.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2020. p. 71
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2102
Keywords
dengue, control and prevention, community empowerment, diagnostic and case reporting
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-176142 (URN)978-91-7855-383-9 (ISBN)978-91-7855-382-2 (ISBN)
Public defence
2020-11-17, Zoom Meeting: https://umu.zoom.us/j/61800219535, Password zoom meeting: 382146, Umeå, 08:30 (English)
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Available from: 2020-10-27 Created: 2020-10-21 Last updated: 2026-05-29Bibliographically approved

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Sulistyawati, SulistyawatiNilsson, MariaRocklöv, JoacimAndersson, CamillaHolmner, Åsa

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