Dengue hemorrhagic fever: knowledge, attitude and practice in Ang Thong Province, Thailand

A cross-sectional study was carried out between July 1998 and June 1999 to identify dengue virus-infected patients under age 15 admitted to seven government hospitals in Ang Thong Province, a central region of Thailand, and to assess the knowledge, attitude, and practice (KAP) of their care takers. To differentiate dengue cases, clinical evaluation and laboratory diagnosis were used. Serum samples were collected from 90 admitted children and also from 80 healthy students. The dengue cases were classified as dengue fever (9 cases, 12.2%) and dengue hemorrhagic fever (DHF: 65 cases, 87.8%). Nine patients had dengue shock syndrome, but no death occurred. With serological confirmation, primary antibody response was observed in 8 (11.3%) and definite secondary infection in 49 (69%). Out of 41 serum samples, 14 (34.1%) were positive for dengue virus isolation: dengue serotypes 1, 2 or 3. A total of 131 care takers of enrolled children were interviewed in the context of KAP in DHF. The majority of them were mothers with primary school education level. Half of the care takers were workers. DHF knowledge of the care takers of the dengue cases, non-cases, and healthy students was almost the same. However, the care takers of dengue cases recognized petechiae as a danger sign, p-value of 0.006. They had a higher response in prevention, control and treatment of DHF than the other two groups after their children were admitted to hospital, p-value of 0.000. The results indicated that DHF remains a public health problem in this area and the people need more understanding of the disease. Continuous campaigns are required for community participation so as to prevent and control DHF successfully.