Assessing Dengue Fever Awareness:

Insights from Rural OPD patients at CHC, Rajasthan (2025)

Shreenidhi Joshi¹, Sakshi Chaturvedi¹*, Chakrapani Chaturvedi², Shivani Choudhary²,

Richa Kumari³, Monika³

¹Associate Professor, Faculty of Nursing, Banasthali Vidyapith, Rajasthan, India.

²Faculty of Nursing, Banasthali Vidyapith, Rajasthan, India.

*Corresponding Author Email: chaturvedimrssakshi@gmail.com

ABSTRACT:

Background: Dengue fever is a viral illness transmitted primarily by the Aedes mosquito, particularly Aedes aegypti, causing significant morbidity and mortality. According to NVBDCP survey report 2023, India accounts, 289235 dengue cases and recorded 485 deaths. This study focuses on assessment of domains of knowledge deficiency related to dengue fever for further public health intervention. Method: A descriptive cross-sectional study was conducted at CHC, Rural, Rajasthan, where 50 OPD patients aged 21 or above were surveyed using a quantitative approach and convenient sampling technique. The patients visiting the OPD were given a knowledge-based questionnaire in Hindi and also in local language to fill out. Result: This study shows that most patients are unaware of key facts about dengue fever. Only 18% of patients have heard of break-bone fever, another name for dengue. Additionally, 58% do not know the symptoms of the disease. Most patients, 82%, were not aware of when dengue mosquitoes are active. Furthermore, 56% do not know who is at risk for dengue or that rashes are a symptom. Many people, 36%, lack knowledge about the most common season for dengue fever and that it causes a decrease in platelet count and pattern of fever. However, 70% were familiar with home-based remedies, such as goat milk and papaya leaf juice, for treating dengue. On the other hand, 42% mistakenly believe that dengue is transmitted from person to person. Conclusion: This study shows that the people living in rural community of Rajasthan needs more education and campaigns about preventing and controlling dengue, which will help stop diseases spread by vectors that are common in the area.

KEYWORDS: Dengue-fever, patients, knowledge, literacy, assessment, rural communities, prevention, treatment, Vector borne-disease, Vector control, Mosquitoes.

INTRODUCTION:

Dengue, one of the perilous public health threats among the vector-borne maladies, escalated cases found in land of warm temperatures and moderate seasonal variations on the globe from last two decades.¹^,² As per WHO, above 6.5 million dengue cases and 7300 deaths, reported globally in 2023¹. An infected mosquito female Aedes aegypti with any of 4 dengue virus serotypes (DENV) is the cause for incidence of dengue, featured by daytime biting, flies up to 400m in height, dark color and white blotched pattern so also called as ‘tiger mosquito’, breed in standing water near to human dwellings¹^,³^,⁴^,⁵^,⁶. Another dengue-causing species, Aedes albopictus, which is a cold climate survivor, so, found in temperate region⁷. The dengue cases in India, spikes in the post-monsoon period. In 2019, India reported over 1.5 lakh dengue cases and 166 deaths. In 2023, more than 2.8 lakh dengue related cases reported and 485 deaths recorded⁸. Dengue may get severe from undifferentiated fever to dengue haemorrhagic fever (DHF) and Dengue shock syndrome (DSS), further contributes to multi-organ failure⁹. Its incubation period is 4–10 days after the bite of an infected mosquito. High grade fever (104°F) following headache, rear eye pain, vomiting, swollen glands, rashes, Joint and muscle pain are the symptoms of dengue fever whereas severe dengue fever manifested with Plasma leaking, continual bleeding, critical organ damage¹^,⁹^,¹⁰^,¹¹. Disease burden could only be declined through vector control, optimal case management, public education and community participation¹²^,¹³^,¹⁴. For prevention and control of dengue and 5 more vector borne diseases, an umbrella scheme, NVBDCP (National Vector Borne Disease Control Programme) launched by Government at national level with the objective of reducing dengue related mortality morbidity as well as burden of disease¹⁵. According to NVBDCP report, Rajasthan reported 13,706 dengue cases and 17 deaths in 2019 although, 13,924 cases and 14 deaths related to dengue in 2023⁸. Geographically, Rajasthan is dry and water-scarce region, thus, drinking water stored in the pots and takas which become the breeding ground for the mosquitoes leads to frequent increase in dengue cases. Sharma et.al., (2023) investigated 41.17 % dengue cases from 68 suspected patients at Sahawa Village of Churu district of Rajasthan¹⁶. In Prasad & Kumar (2021) study, an entomological survey was conducted in 3645 houses of Udaipur district of south Rajasthan where there 1284 containers (coolers drums, tires, pots and discarded buckets) were found positive for dengue mosquito Larvae out of 8733 containers on inspection¹⁷. Hence, the knowledge deficiency is one of the reasons for prevalence of dengue. Therefore, the present study focused on assessment of dengue knowledge-based assessment among rural OPD patients at Community Health Centre (CHC), Rajasthan 2025. This study aims to identify areas that require public health interventions related to dengue among rural community.

MATERIALS AND METHODS:

Materials:

Research design and setting:

The study's design and setting were carefully crafted. This descriptive cross-sectional study took place from November 2024 to March 2025, adopting a quantitative approach to uncover the level of dengue knowledge among OPD patients belongs to rural community and were visiting Community Health Centre (CHC) Rajasthan, India. The CHC, a bustling healthcare facility, provided an ideal setting to explore the awareness of dengue fever among patients seeking routine medical care.

Sample and sampling: In the study, a total of 50 patients from the Outpatient Department (OPD) participated through convenient sampling, shedding light on their understanding of dengue awareness, prevention, and treatment.

Method of data collection: Between September 2024 and October 2025, each participant completed a self-structured which was prepared in Hindi and also in local language, pre-validated questionnaire, providing valuable insights into their knowledge. Our assessment tool was divided into two crucial sections. Section I collected essential socio-demographic data, such as age, gender, and occupation, while Section II consisted of 15 close-ended questions that probed their awareness of dengue fever. Each correct response earned a point, while incorrect answers received zeros, effectively quantifying their knowledge. Sample inclusion criteria: To ensure the study's validity, we established clear inclusion criteria: participants had to be OPD patients aged 21 years or older. Sample exclusion criteria: On the other hand, we excluded those under 21, emergency patients, In-Patient Department (IPD) patients, and antenatal mothers, as their unique circumstances might have biased the results.

Ethical permission: In terms of ethical consideration, we obtained approval from the Institutional Review Board (IRB) before commencing the data collection process. We also ensured that participants gave verbal consent beforehand, guaranteeing that they understood the study's objectives and maintaining data privacy.

Data analysis: The data gathered from the dengue knowledge assessment were meticulously analysed using MS Excel. We employed descriptive statistics, including percentages, frequencies, means, modes, medians, and standard deviations, to summarize the findings. The results were subsequently presented in tables and illustrated graphically, rendering the data more accessible and impactful.

RESULT:

Total of 50 OPD patients were undertaken for present study. From the pool of participants, 56% (28) patients were in the age-group of 21-30 years, 16% (8) patients come under 31-40 years, 12% (6) patients belong to 41-50 years of age-group, 12% (6) of patients falls within 51-60 age-group and 4% (2) of the patients comes above the 60 years of age. The mean age of OPD patients were 34.22±14.11. 52% (26) patients were males and 48% (24) patients were females. 24% (12) patients completed primary education only, 26% (13) accomplished secondary education, 16% (8) patients passed higher secondary, while 18% (9) were graduates, 8% (4) were post-Graduates; and 8% (4) are diploma holders. 70% (35) patients reside in Pucca house while 30% (15) lives in Kutcha house. Knowledge analysis revealed that only 18% of participants were able to talk correctly about dengue fever 82% OPD patients aware that dengue is a life-threatening disease if not treated early with a mean score 0.82±0.38. 90% (0.9±0.3) conscious that mosquitoes are the main transmission route of dengue fever, and it is most prevalent during rainy season, as acknowledged by 64% (0.64±0.48) of patients. 78% (0.78±0.41) knew of the prevention technique for dengue. Home remedies such as goat milk and papaya juice for dengue prevention and treatment is recognized by 70% (0.7±0.45). And 64% (0.64±0.48) aware that dengue results in a decrease in platelet count. 58% (0.58 ± 0.5) were not aware of all the symptoms, and 44% (0.44±0.5) of OPD patients associate rashes with dengue. [

Table 1]. Mean score attained by OPD patients through knowledge-based assessment questionnaire was 9.28 ± 2.07. The knowledge of dengue fever treatment availability had the highest mean accurate response i.e., 92% (0.92±0.27), whereas the knowledge of bone-break fever and the dengue mosquito's peak biting period had the lowest mean accurate response i.e., 18% (0.18±0.38) [Error! Reference source not found.] The study's average percentage of awareness regarding dengue, its transmission route, symptoms, risk factors, prevention and treatment was 61.8% (9.28± 2.07), with a standard error of 0.3.

DISCUSSION:

Key Findings suggested that there is Limited Awareness of Dengue Only 18% of respondents correctly identified what dengue is, meaning that basic awareness is alarmingly low. 42% recognized its symptoms, but a large percentage (58%) still lack symptom-related knowledge, which can delay medical intervention. Findings also suggested that Poor Understanding of Transmission and Risk Factors Only 36% knew that dengue spreads through mosquito bites, showing a gap in understanding of its vector-based transmission. The majority (70%) didn't know that dengue is most common in specific seasons, which may hinder preventive actions during high-risk periods. Only 24% knew that the dengue mosquito bites during the day, indicating misinformation about mosquito behaviour. Findings of this study about dengue fever Knowledge of Severity and Treatment were 82% correctly identified that dengue is life-threatening and that treatment options exist, showing awareness of its seriousness. 78% understood that dengue does not spread person-to-person, indicating correct knowledge in this aspect.

Table 1 : Item wise knowledge assessment and participant response about dengue fever

S. No.	Questions	Correct Response		Incorrect Response
S. No.	Questions	Frequency	Percentage (%)	Frequency	Percentage(%)
1	What is dengue	9	18	41	82
2	What are the symptoms of dengue	21	42	29	58
3	What is the main transmission route of dengue	45	90	5	10
4	In which season dengue fever is most common	32	64	18	36
5	When does dengue mosquito bites	9	18	41	82
6	Who is most at risk of dengue	22	44	28	56
7	Which things start decreasing in our body when we have dengue fever	32	64	18	36
8	Does dengue fever cause rashes on the body	22	44	28	56
9	How to prevent dengue	39	78	11	22
10	What are the home remedies to prevent dengue	35	70	15	30
11	Is dengue fever spread from person to person	29	78	11	22
12	Do you already know about the dengue fever	10	80	10	20
13	Do you know the early symptoms of dengue fever	42	84	8	16
14	Is there any treatment available for dengue fever	46	92	4	8
15	Is dengue fever life-threatening diseas	41	82	9	18

Figure 1: Item wise knowledge Mean about Dengue Fever