INTRODUCTION

Dengue is a disease caused by the dengue virus. There are 4 serotypes of dengue virus:
DEN-1,DEN-1,DEN-1 and DEN-4 which belong to Flaviridae family. The virus is transmitted to
man by the bite of infected mosquitoes. The mosquito vectors are Aedes Aegypti and Aedes
Albopictus (CDC, 2008). There are two main forms of dengue disease, dengue fever (DF) and
the more severe dengue haemorrhagic fever (DHF). Infection with any of the four serotypes can
produce a broad range of clinical manifestations including asymptomatic infection, mild flu-like
symptoms and the more severe haemorrhagic fever (Pai H, 2005).

Despite progress with the development and clinical evaluation of vaccines against dengue
virus infection, no such vaccine is on the market yet (Halstead SB, 2012) and there is no specific
treatment against DF. Thus, controlling the populations of dengue virus infection vector
mosquitoes, especially Aedes aegypti and Aedes albopictus, and limiting their dispersal to new
regions is crucial to prevent dengue virus infection transmission (WHO, 2011).

Dengue virus infection has globally become a major public health concern since the
incidence of DF has increased more than 30-fold over the last five decades (WHO, 2009) and the
disease is now endemic in 128 countries (Brady OJ, 2012) which include Malaysia. Malaysia
reported 131 dengue-related deaths and 68,144 infections on 2013. That compares with 38 deaths
and 18,923 cases over the same period on 2012. Selangor state has the highest number of dengue
cases nationwide, at 34,404 and 51 deaths from Jan. 30 to Aug. 30 2013, compared with 8,694
cases and 10 deaths during the same period on 2012 (C.Fernendez, 2014)

Therefore, this study is carried out to assess the level of knowledge, attitudes and practices
concerning dengue prevention and its vector, the Aedes mosquitoes among students residing in
Varsity Lodge, Cyberjaya which resided by 2,000 students.
OBJECTIVES

1. To assess the knowledge of residents in mutiara villa varsity lodge regarding dengue
fever or dengue hemorrhagic fever.
2. To assess the attitude and practice among residents of mutiara villa varsity lodge
regarding dengue fever and ways in preventing it.
3. To study the relationship between good knowledge, attitude and practice on dengue
among residents of mutiara villa varsity lodge to the prevalence of dengue fever.

HYPOTHESIS

H0 : There is no relationship between good knowledge, attitude and practice on dengue

among residents of mutiara villa varsity lodge to the prevalence of dengue fever.

HA : There is a relationship between good knowledge, attitude and practice on dengue

among residents of mutiara villa varsity lodge to the prevalence of dengue fever.
LITERATURE REVIEWS

KNOWLEDGE

A study done in Jalan Keramat, Kuala Lumpur shows that almost all (98%)survey
respondents had heard of dengue. 85% of the respondents reported that television is the main
source of information on dengue. Only 73% of the respondents were aware that dengue was
transmitted by the bite of Aedes mosquito. The majority (78.2%), of survey respondents able to
state at least one symptom or clinical sign of dengue fever and the clinical presentation most
recognized is sudden onset of fever. However, only 42% of the survey respondents were able to
report correctly the biting times of the Aedes mosquito that was at dusk and dawn. Only 35% of
the respondents answer correctly that both preventing mosquito bites and bredding as the
effective measures against dengue fever. 71% of the respondents idenftified clogged drains as the
most possible place for the mosquito to breed follower by inner lining of tyres, opened coconut
shells, receptacles of broken glasses, water storage systems, flower vases and banana/caladium
trees. A high percentage of the respondents (69.2%) correctly identified Aedes mosquito with its
black and white stried legs. (Wan Rozita WM, Yao BW, Veronica S, Muhammad AK, 2006)

A study in several rural districts in Kuala Kangsar shows that most respondents attributed
the cause of dengue to mosquitoes, while only a handful could name virus as the cause and the
majority of respondents were aware of at least one sign or symptom of dengue. Despite knowing
that stagnant water is a breeding site for Aedes and the wide availability of piped water, most of
the respondents still stored water.( Farizah Hairi, Cyril-HS Ong, Anwar Suhaimi,2002)

In another study conducted in Safdarjang hospital in New Delhi, 79.8% respondents knew
about breeding places of mosquitoes. Coolers as the most probable breeding site (for
mosquitoes) was named by 42.4 percent respondents. Despite the knowledge, out of 178 (35.6
%) persons having cooler in their house, 98 (55.0 %) said that they never check coolers for
mosquito breeding. (Indian Journal of Community Medicine Vol. 31, No. 3, July-September,
2006)
 Most respondents from a study in Jamaica were not able to correctly relate the symptoms
of dengue apart from a few who identified fever, an obvious symptom. Fever was also the most
frequently recalled symptom in a similar study conducted in India. Almost half the respondents
rejected pain behind the ears (which is often due to swollen lymph glands) as a plausible
symptom. This could be because pain behind the ears is not a commonly described symptom or
perhaps because participants had not personally experienced the disease, nor witnessed a case
from a close relative or friend. The poor knowledge of the spectrum of symptoms associated with
dengue means it may be confused with most other causes of fever such as the flu. The
implication of this is that presentation to the clinic may be delayed until complications arise.
Knowledge of means of dengue transmission was equivocal with respect to possible transmission
through blood transfusion and needle stick injury: approximately 45% of the participants thought
the disease could be contracted through blood transfusion or needle stick injury. However, it is
noteworthy that it is in rare instances (during the acute stage of the disease) that the virus may be
passed in blood or organ transplant. While 40% of participants were aware that person to person
contact cannot lead to acquisition of dengue, there still remained an appreciable 60% of
respondents who needed to be educated appropriately in order to ensure that they had correct
information.( F Shuaib, D Todd,2010)

ATTITUDES

Based on a study conducted in Jalan Keramat, Kuala Lumpur, the majority of respondents
(90% and above) agreed that mosquito bites were dangerous and the consequences of mosquito
bited were also serious. It was noted that 94.7% agreed that preventive measures were needed to
prevent dengue fever and 96.2 were willing to cooperate with any activities organized by the
health authorities such as fogging to eradicate Aedes mosquito. A slightly lower agreement (72.9)
was shown when they were asked whether penalty should be given to those who bred mosquito
in their area. (Wan Rozita WM, Yao BW, Veronica S, Muhammad AK, 2006)
 Most of the participants in s study conducted in Central Nepal strongly agreed (91%) that
DF is a serious illness. Thus, they effectively appreciated the serious nature of the disease. None
of the research participants strongly disagreed on facts related to DF (Meghnath Dhimal,
Krishna Kumar Aryal, 2014)

PRACTICES

Based on a study conducted in Jalan Keramat, Kuala Lumpur, 53% of the respondents
cleaned their water storage and a very low percentage (5.3%) did not clean it at all. 88% of them
preferred to use aerosol compared to mosquito coil. Almost 80% kept their place clean by
avoiding shrubby areas whereas more that half kept drains free from blockage. It was found that
only 25% of the respondents had all water containers tghtly covered, 13% applied mosquito
repellents to expose body part and only 10% used mosquito net. 68% refused to wear long
sleeved clothes because of the hot weather. For respondents who had plants to be watered, more
that 75% of them did take dengue preventive measure such as removed stagnant water under
plant container and changed water for the plants at least once a week. (Wan Rozita WM, Yao
BW, Veronica S, Muhammad AK, 2006)

The measures to reduce mosquito-man contact that were most commonly used by the
majority of participants in a study conducted in Central Nepal were: covering water containers in
the home (95%), cutting down bushes in the yard (94%), eliminating standing water around the
house (95%), disposing of water holding containers such as tyres, parts of automobiles, plastic
bottles, cracked pots, etc. (91%), preventing any stagnant water (90%), cleaning out
garbage/trash (92%), using window screens to keep mosquitoes out of the house (81%), using
insecticide sprays (80%), turning containers upside down to avoid water collection (90%) and
using mosquito coils (Meghnath Dhimal, Krishna Kumar Aryal, 2014)

Most participants in a study conducted in Jamaica strongly that dengue is a serious illness.
Thus, 87.2% of participants effectively appreciated the serious nature of the disease. Also, about
80% of participants strongly agreed (40.9%) or agreed (39.4%) that the disease is preventable.
Only 21.2% of the respondents thought they were at risk of contracting dengue fever (5.8%
strongly agreed and 15.4% agreed). Some participants undertook preventive activities to avoid
contact with mosquitoes. For instance, 61.7% used insecticide sprays, 56.4% employed
professional pest control services, 22.9% screened their windows from mosquitoes and 4.8%
used bed nets during the night. .( F Shuaib, D Todd,2010)

METHODOLOGY

STUDY LOCATION

As the diseases increased through out the years especially among the students, study
carried out in Varsity Lodge, Cyberjaya. The area consists of three blocks which is block
A, block B and block C. Total residents in Varsity Lodge, Cyberjaya are 2000 peoples.
Most residents who live here are students of Cyberjaya University College of Medical
Sciences and Lim Kok Wing University. There is a mall in front of the blocks. The
nearest hospital from this area are Hospital Putrajaya which is 2.6 km away from this
area. Another university which Multimedia University that 1.2 km from this area.

STUDY DESIGN
Cross-sectional study

DURATION OF STUDY

SAMPLE POPULATION

This study involves all adults age 18 years old and above in the study location. Total
residents in study location are 2000 people which consist of majority Malay residents.
 INCLUSION CRITERIA

Adult aged 18 and above

EXCLUSION CRITERIA

Hearing impaired

Mentally retarded

Visually challenged

NON-RESPONDENT

Refuse to participate in this study

SAMPLING FRAME

Residents who are staying in Varsity Lodge, Cyberjaya that fulfill the inclusion
criteria and exclusion criteria.

SAMPLING UNIT

A residents from Varsity Lodge, Cyberjaya that meets all the inclusion criteria and
exclusion criteria.

SAMPLE SIZE

The prevalence of dengue in Malaysia is 80%

Formula:

Where,
 n= sample size

p= prevalence of dengue in Malaysia.

Z= z-score, the value from the standard normal distribution reflecting the confidence
level that will be used (e.g. 1.645 for a 90% confidence interval, 1.96 for a 95%
confidence interval, 2.58 for a 99% confidence interval). In this case, we are planning a
study to generate a 95% confidence interval (Z= 1.96).

E= desired margin of error.

Calculations:

Prevalence of dengue in Malaysia is 80%

SAMPLING METHOD & FLOW CHART

There is three blocks in Varsity Lodge, Cyberjaya so we will select stratified random
sampling.
From each of the selected blocks, only 75 samples will be chosen via simple random
sampling (drawing lots).