Knowledge, Attitudes and Practises of Dengue Prevention Between Dengue Sustained Hotspots and Non-Sustained Hotspots in Singapore: A Cross-Sectional Study

Dengue sustained hotspots (SHS) have resulted in a significant public health burden. In our study, we aimed to evaluate knowledge, attitudes and practices (KAP) of dengue prevention between residents residing in dengue sustained hotspots and non-sustained hotspots (NSHS) in Singapore. A cross-sectional study with convenience sampling was conducted using digital survey in randomly selected SHS and NSHS residential areas. Inclusion criteria were residents aged 21 or older and residing in the same housing unit in 2019 and 2020. Chi-square test and T-test were used for comparison analysis of categorical and continuous variables, respectively. Single and multiple logistic regression were performed using Stata (version 13.1.226) with significance level alpha at P-value <0.05. A total of 466 respondents completed the self-administered, anonymous survey. Age, educational level, marital status, housing type, years staying in house, gross monthly income, hours at home (weekends) and hours of air-conditioning used (weekends) were significantly different between SHS and NSHS [P-value <0.05]. There were no significant difference in mean scores for Knowledge [SHS(24.66) vs. NSHS(24.37); P:0.18], Attitudes [SHS(10.38) vs NSHS(10.16); P:0.08] and Practices [SHS(9.27) vs NSHS(8.80); P:0.16] sections. Significant SHS-associated factors identified were age group 41–50 years old [Adjusted Odds Ratio (AOR):2.50; 95%CI:1.25-5.03], Malay (AOR:0.41; 95%CI:0.17-0.98), up to secondary school education (AOR:0.22; 95%CI:0.07-0.65), private condominium: AOR:1.99; 95%CI:1.17-3.39), residing in same household unit for 2-5 years (AOR:4.10; 95%CI:2.44-6.88), respondents who know that mosquito can breed in open container with stagnant water (AOR:0.25; 95%CI:0.06-0.98), disagree that reducing Aedes mosquitoes is the only way to prevent dengue: (AOR:1.88; 95%CI:1.19-3.00) and go to clinic/hospital even without severe symptoms: (AOR:0.61; 95%CI:0.39-0.95). These independently associated factors would be useful to strengthen community outreach campaign to reduce the risk of sustained dengue hotspots.