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Title: Community beliefs and practices about dengue in Puerto Rico

Author
item PEREZ-GUERRA, CARMEN - CDC, SAN JUAN, PR
item ZIELINSKI-GUTIERREZ, EMILY - CDC, SAN JUAN, PR
item VARGAS-TORRES, DANULKA - Centers For Disease Control And Prevention (CDC) - United States
item Clark, Gary

Submitted to: Journal of the Pan American Health Organization
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/4/2008
Publication Date: 3/15/2009
Citation: Perez-Guerra, C. L., Zielinski-Gutierrez, E., Vargas-Torres, D., Clark, G. G. 2009. Community beliefs and practices about dengue in Puerto Rico. Journal of the Pan American Health Organization. 25(3):218-226.

Interpretive Summary: In late 2003, 11 focus groups were held in San Juan, Puerto Rico to explore the attitudes of residents towards dengue (a viral disease transmitted by the Aedes aegypti mosquito) and its prevention. Women considered dengue important because of its economic, emotional, and health impact and were concerned more often than men about insufficient garbage removal and water disposal. Participants with previous dengue diagnosis were more concerned about risk of disease, knowledgeable of dengue and its prevention, and recommended use of repellents more often than their counterparts without a previous dengue diagnosis. Participants suggested strategies to motivate residents’ actions including working with governmental agencies to address structural problems that increase mosquito populations; improving access to information on garbage collection and water disposal through telephone hotlines; increasing publicity and information about dengue by mass media campaigns; and educating health professionals.

Technical Abstract: In spite of long-term endemicity and repeated government and private efforts, effective, sustained community participation for dengue prevention is still a challenge in Puerto Rico. This study explored differences found in interviews conducted in 2001 in attitudes toward dengue and its prevention by respondent’s gender and whether they had a prior dengue infection. Findings may be used to develop messages to promote Aedes aegypti control practices. Methods. From September to October, 2003, 11 focus groups were conducted in San Juan, Puerto Rico. Fifty-nine persons (35 women/24 men), =18 years of age that had been identified through the Puerto Rico dengue surveillance system participated in the focus groups. Analysis was based on grounded theory. Results. Women considered dengue important because of its economic, emotional, and health impact and were concerned more often than men about insufficient garbage removal and water disposal. Participants with previous dengue diagnosis were more concerned about risk of disease, knowledgeable of dengue and its prevention, and recommended use of repellents more often than their counterparts without a previous dengue diagnosis. Barriers to sustained dengue prevention included misconceptions from outdated educational materials, “invisibility” of dengue compared to chronic diseases, and lack of acceptance of responsibility for dengue prevention. Conclusions. Suggested strategies to motivate residents’ actions included working with governmental agencies to address structural problems that increase mosquito populations; improving access to information on garbage collection and water disposal through telephone hotlines; increasing publicity and information about dengue by mass media campaigns; and educating health professionals.