Dengue fever, caused by the dengue virus and primarily transmitted through the bite of infected Aedes mosquitoes, has emerged as a significant public health concern in many parts of the world. This includes Shimla, a picturesque hill station nestled in the Himalayan foothills of Himachal Pradesh, India. Shimla's serene landscapes, pleasant climate, and vibrant culture have long attracted tourists and outdoor enthusiasts, making it a hub for recreational activities. However, amidst the lush greenery and scenic beauty that defines Shimla, a lurking threat has emerged - the Aedes mosquito, capable of transmitting the dengue virus, has found its way into the region, necessitating a comprehensive assessment of public awareness and knowledge regarding this infectious disease [1-4].

Dengue fever is characterized by a sudden onset of high fever, severe headache, joint and muscle pain, and a rash. In severe cases, it can lead to dengue hemorrhagic fever or dengue shock syndrome, both of which can be life-threatening if not promptly diagnosed and treated. The rapid spread of dengue fever in Shimla and the increasing number of reported cases have raised concerns among health authorities and the local population [4-8].

Given the potentially devastating impact of dengue fever and the urgent need for proactive measures to curb its spread, it is paramount to gauge the level of awareness and knowledge among the residents and visitors of Shimla. Understanding the depth of knowledge about dengue, its transmission, symptoms, and preventive measures among the general public is the first step in combating this mosquito-borne menace effectively.

This present study seeks to bridge the existing gap in understanding dengue fever by conducting a rigorous assessment of awareness and knowledge levels among the general public in Shimla. The insights gained from this research will serve as a foundational resource for designing targeted public health campaigns and educational programs. These initiatives will empower the community to take proactive measures against dengue, ranging from mosquito control practices to early symptom recognition and timely medical intervention. 

Ultimately, this collective effort will contribute to creating a safer and healthier environment in Shimla, preserving its natural beauty and ecological balance while safeguarding the overall well-being, safety, and quality of life of both residents and visitors.

Objectives of the Study

To evaluate the awareness and knowledge regarding Dengue fever among general public of Shimla

Research Approach

Descriptive

Research Design

Cross-sectional survey design

Study Area

District Shimla, Himachal Pradesh

Study Duration

Between April 2023 to June 2023

Study Population

The study's target population encompassed all adults aged 18 and above who had been residents of Himachal Pradesh for a minimum of 12 months

Sample Size 

A robust sample size of 400 adults was determined using a 95 percent confidence level, an estimated knowledge level of 50 percent regarding risk factors and prevention of cardiovascular disease, and a precise absolute error margin of 5 percent. Additionally, a conservative non-response rate of 5% was considered to account for incomplete or missing data. This approach ensured adequate statistical power and improved the reliability and generalizability of the study findings.

Study Tool

A Google Form–based questionnaire consisting of questions related to socio-demographic characteristics and knowledge regarding preventive factors and practices for elbow pain was developed. Prior to the main data collection, the questionnaire was pre-tested on a small group of participants to assess clarity, relevance, and comprehensibility of the items. Based on the feedback received, necessary modifications were made to improve wording and ensure that respondents could easily understand and accurately answer all questions.

Description of Tool

Demographic Data Survey Instrument: The demographic form elicited comprehensive information on participants’ background characteristics, including age, marital status, religion, employment status, and level of education. In addition to these core variables, details related to socio-economic conditions, family structure, and living arrangements were also gathered. This information helped in developing a clearer understanding of the sample profile and provided essential context for the analysis and interpretation of the study findings.

Questionnaire

The questionnaire contains 20 structured knowledge related questions regarding Preventive Factors and Practices for elbow Pain. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80% (16-20) = very good, 60-79% (12-15) = Good, 41-59% (8-11) = Fair, <40% (< 8) = poor

Validity of Tool 

By the experts in this field

Data Collection

Data was collected under the close guidance and supervision of the assigned supervisors to ensure accuracy and methodological rigor throughout the process. A structured Google Form questionnaire was designed and circulated among residents of District Bilaspur, Himachal Pradesh, to obtain relevant responses. The questionnaire was disseminated using various online modes such as e-mail and widely used social media platforms, including WhatsApp groups, Facebook, Instagram, and LinkedIn. Data collection was continued over a defined period until a total of 400 valid responses were successfully obtained for analysis.

Data Analysis

Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage. 

Ethical Considerations

Participants confidentiality and anonymity were maintained. 

The goal of the current study was to assess the knowledge regarding Dengue fever among general public of Shimla through a non-experimental descriptive survey. A total of 400 respondents including 271 (67.75%) were from urban area and 129(32.25%) were from rural area were participated in the study. Table 1 shows the Knowledge regarding Dengue Fever among Study Participant. 

In the present study 29.25% (117) participants had very good knowledge (16-20 marks) towards Dengue fever, 39.0% (156) had good knowledge (12-15 marks), 18.75% (75) had fair knowledge (8-11 marks) and 13% (52) having poor knowledge (<8 marks). Table 2 shows the knowledge scores towards dengue fever among study participants.

Table 1: Knowledge regarding Dengue Fever among Study Participant

Table 2: Knowledge Scores towards Dengue Fever among Study Participants

Dengue fever, caused by the dengue virus and transmitted primarily by Aedes mosquitoes, poses a growing threat to public health in many regions, including Shimla, India. This discussion section delves into the findings of the study, highlighting the knowledge levels of the general public in Shimla regarding dengue fever and comparing these findings with studies conducted in other areas. The assessment aimed to uncover the current state of awareness and knowledge concerning dengue fever, its transmission, symptoms, and preventive measures among the residents and visitors of Shimla.

The study evaluated the knowledge levels of 400 respondents in Shimla, with 67.75% residing in urban areas and 32.25% in rural areas. The results reveal a range of knowledge among participants concerning dengue fever. A significant portion (72.25%) of respondents correctly identified dengue fever and its causative agent, showcasing a foundational understanding of the disease.

Approximately 69.5% of participants demonstrated awareness of how dengue fever is transmitted, recognizing the role of Aedes mosquitoes in disease transmission. About 52.75% of respondents correctly identified the common geographical regions where dengue fever is prevalent. This knowledge can guide travelers and residents in taking preventive measures. Approximately 60.75% of participants recognized common risk factors associated with contracting dengue fever, which is crucial for individuals to take precautions when engaging in outdoor activities.

While 47.25% knew that dengue fever is not spread from person to person, it's noteworthy that a substantial portion still held misconceptions about its transmission. This highlights the need for education on the non-contagious nature of the disease. A substantial 66% of respondents correctly identified the typical clinical features or symptoms of dengue fever, which can facilitate early recognition and medical attention. Approximately 58% of participants were aware of how healthcare professionals diagnose dengue fever, signifying a reasonable understanding of this aspect.

An encouraging 69% recognized the criticality of early diagnosis and treatment, which is essential to prevent complications. While 65.5% knew about potential complications arising from untreated dengue fever, there is room for improvement in understanding the disease's severity. 65% of respondents correctly identified measures to protect themselves from dengue fever infection, indicating a significant level of awareness regarding preventive actions. 58.75% recognized the existence of specific preventive measures for individuals living in endemic areas, contributing to the safety of local residents.

An impressive 68.75% could name common breeding sites for Aedes mosquitoes, the vectors for dengue fever. This knowledge is crucial for avoiding high-risk areas, while 45.25% were aware of the absence of vaccines for dengue fever prevention, the understanding of vaccine unavailability is important to avoid misconceptions.53.25% of participants correctly identified what individuals should do if they suspect they have dengue fever, reinforcing the importance of seeking medical attention promptly. 59.25% recognized the significance of using mosquito repellents and bed nets in endemic areas, demonstrating an understanding of preventive measures. 64% of respondents had knowledge of how healthcare professionals typically treat dengue fever, which is essential for informed healthcare decisions.

Approximately 40.25% were aware of specific treatments or medications for severe dengue (dengue hemorrhagic fever), indicating room for improvement in understanding this critical aspect. An encouraging 58.5% identified the presence of public health initiatives in their region to control dengue fever, indicating community awareness of disease control efforts. 64.5% recognized the role of individuals and communities in raising awareness about dengue fever, reflecting a willingness to engage in educational initiatives. Around 40.5% were aware of the existence of misconceptions or myths about dengue fever, indicating a level of critical thinking about the disease. Comparing these findings with studies conducted in various regions, residents and visitors of Shimla exhibit a moderate to good level of awareness and knowledge regarding dengue fever [7-14]. While some aspects align with findings from other studies, such as the recognition of transmission modes and clinical symptoms, there are notable knowledge gaps in areas like severe dengue treatment and geographic prevalence. This underscores the need for targeted education and awareness campaigns in Shimla to enhance understanding further.

Assessing the knowledge levels regarding dengue fever among the general public in Shimla has revealed a commendable level of awareness on many aspects of the disease. However, there are opportunities for improvement in specific areas, particularly regarding severe dengue treatment, geographic prevalence, and misconceptions. Addressing these knowledge gaps through tailored public health campaigns and educational initiatives is essential to combat the dengue menace effectively. This collective effort will contribute to creating a safer and healthier environment in Shimla, preserving its natural beauty and safeguarding the well-being of its residents and visitors.

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