Knowledge, attitude, and practice on prevention of dengue among postgraduate international students in a public university in Malaysia

Introduction: Dengue infection is one of the major vector-borne diseases and has become a public health concern throughout the world. Dengue fever has also become a burden among outsiders who travel to dengue endemic countries. Objective: This study aims to identify the level of knowledge, attitude and practice on prevention of dengue infection among postgraduate international students in Universiti Putra Malaysia, Serdang and its predictors. Methodology: A cross-sectional study was conducted among the postgraduate international students enrolled full-time in UPM using a multi-stage random sampling and proportionate to the number of students from each selected faculty. Data were collected using validated and self-administrated questionnaire. The collected data was computed and analyzed using IBM Statistical Package for Social Science (SPSS) version 22. Inferential statistics was used to assess the association between categorical variables using either Chi-Square or Fisher’s exact test. The final models for predictors of good knowledge, attitude and practice were analyzed using logistic regression analyses. All the associations and predictors were considered significant at P less than 0.05. Result: There were a total of 327 international students with 93.4% response rate. Majority of the students were male (70.3%), single (51.1%), master (56.3%) and Asians (52.3%) with median age of 32 (IQR 10). Most of the respondents showed good knowledge (69.7%), positive attitude (51.4%) and poor practice (60.9%) with 77.7% of the students having high perceived influence of mass media towards dengue infection. Predictors of good knowledge were being a female (aOR = 2.236, 95% CI = 1.242 – 4.025, P = 0.007), respondents with history of dengue previously (aOR = 12.751, 95% CI =1.674 – 97.136, P = 0.007), those who stayed more than 18 months (aOR = 2.005, 95% CI = 1.240 – 3.242, P = 0.007) and respondents with high influence of mass media (aOR= 3.076, 95% CI = 1.784 – 5.572, P ≤ 0.001). Predictors of positive attitude were, respondents older than 31-year-old (aOR = 1.718, 95% CI = 1.074 – 2.747, P = 0.024), high influence of mass media (aOR = 2.236, 95% CI = 1.242 – 4.025, P = 0.007), living in endemic country (aOR = 1.796, 95% CI =1.055 – 3.055, P = 0.031) and respondents from Africa (aOR = 0.443, 95% CI = 0.262 – 0.748, P = 0.002). Africans (aOR = 0.477, 95% CI = 0.270 – 0.845, P = 0.011) and participants with positive attitude (aOR = 2.928, 95% CI = 1.758 – 4.877, P < 0.001) were predictors of good practice. Conclusion: The outcome of this study showed poor practice level of prevention on dengue, despite the respondents having an average level of knowledge and positive attitude. Hence, knowledge and attitude should be strengthened through the most utilized sources of information by giving ongoing health education and organizing campaigns regarding dengue preventive practices