Knowledge, Attitude, and Practices towards Dengue Fever among University Students in Bangladesh: a cross-sectional study

doi:10.21203/rs.3.rs-5089981/v1

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Knowledge, Attitude, and Practices towards Dengue Fever among University Students in Bangladesh: a cross-sectional study

https://doi.org/10.21203/rs.3.rs-5089981/v1

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Background

Inadequate knowledge, attitude and practices (KAP) on dengue fever (DF) can substantially affect vulnerable people like Bangladeshi university students because of their living status. However, it has never been explored. Therefore, this study was conducted to assess the level of KAP regarding DF among university students of Bangladesh.

Methods

A cross-sectional study was conducted from September 2023 to January 2024 among 671 university students through convenient sampling. All statistical analysis was performed at 0.05 α level and Hosmer-Lemeshow test was checked to certain the Goodness of fit of the logistic regression models.

Results

30.4% of university students had good knowledge on DF and 35.9% had good practice on DF in spite of having higher attitude level (72.28%). Knowledge (aOR:1.7, 95%CI: 1.2–2.5) and attitude (aOR:1.7, 95%CI: 1.2–2.5) were positively associated among participants who had dengue related subjects. Participants who faced dengue cases among their family members (aOR:1.7, 95%CI: 1.2–2.4) had significant level of preventive practices.

Conclusions

Overall knowledge and practice level were poor among university students. Awareness regarding dengue fever should be created among university students. In addition, knowledge and attitude should be converted to preventive practices among these vulnerable groups.

General Practice

Dengue fever

University students

Bangladesh

Knowledge

Attitude and Practice

KAP

Half of the global population stands at risk of dengue infection and the other half remains in dengue-endemic countries. The world witnesses more than five million dengue infection reported from World Health Organization (WHO) regions in 2019, which is about tenfold higher compared to that in 2000 (Giang et al., 2021). In 2023, a historic high of dengue cases was recorded, affecting over 80 countries across all WHO regions. The ongoing transmission, coupled with an unexpected spike in cases since the beginning of 2023, led to over 6.5 million reported cases and more than 7,300 dengue-related deaths (Organization, 2024). Being a global infection, dengue virus (DENV) is endemically present mainly in Latin America and Caribbean countries as well as countries in South Asia where Asia carries 70% of the disease burden.

Due to multiple risk factors like rapid and unplanned urbanization, global warming, and prolonged rainy season promoted dengue outbreaks in recent years in Bangladesh. Additionally, household hazards contribute to producing an increased number of Aedes mosquitoes, Bangladesh has been experiencing successive major dengue outbreaks in recent years (Bonna, Pavel, Mehjabin, & Ali, 2023; M. S. Hossain, Noman, Mamun, & Mosabbir, 2023). There has been a serious endemic of DENV during 2019. After a heterogeneous pause, another severe outbreak of DENV was reported in some Asian countries in 2023 (Akbar et al., 2023). In 2023, the number of cases in Bangladesh had surged to 308,167, a significant rise from the 62,382 cases reported for the whole of 2022. During the same period, the death toll in Bangladesh increased from 281 (CFR 0.45%) to 1,598 (CFR 0.52%) (Organization, 2023).

The increase in mosquito-borne diseases is highly anthropogenic and connected to global climate change, involving high temperatures or rainfall that affects mosquito bionomics (Fouque & Reeder, 2019). However, simple human intervention and behavioural changes can reduce the incidence of dengue patients significantly (Anand, Kumar, Saini, Meena, & Ingle, 2014). On the other hand, education and knowledge regarding mosquito control can lead to improved attitudes of citizens and help them to adopt protective practices (M. A. B. Siddique, Ovi, Ahammed, Chowdhury, & Uddin, 2022). Knowledge, attitude and practice (KAP) is an important cognitive key in public health regarding health prevention and promotion. It involves a range of beliefs about the causes of the disease and exacerbating factors, identification of symptoms, and available methods of treatments and consequences (Ferdous et al., 2020).

University environment is one in which students not only receive education, but also develop personally and socially. This development has a great influence on students during their time at university and also during the rest of their lives, affecting the choices they will make, their values and priorities, their jobs, homes, and communities (García-Álvarez & Faubel, 2020). University students, whether in the healthcare field or not, are an important subgroup of the population whose decisions could impact transmission trends in the future (Abu-Humaidan et al., 2022). In 2023, distribution of dengue fever was detected mostly among the age-group of 21–25 years (30,415 cases) and 26–30 (26,492 cases) years old (Akbar et al., 2023) where almost all university students fall in these age group category (Arafat et al., 2022; Sultana, Mahumud, Sarker, & Hossain, 2016). Moreover, most university students live in dormitory or in-house rent are vital source of dengue virus transmission as they move across the country for educational or family purposes.

University students are a critical group of learners as they have access to authentic knowledge. The authority can easily reach them through universities or different social and digital media platform (Rahman, Sakib, et al., 2023). If these students bear enough knowledge and positive attitudes, they can transfer it to their community. In collaboration with university students, the community can then translate knowledge and attitudes on DF into preventative practices (Rahman, Tanni, et al., 2023).

A number of studies was conducted in Bangladesh regarding the KAP on dengue fever and mosquito control. Most of these studies were carried out in communities or students of a specific areas, such as hilly tracts or city areas (Hamid, 2023; Rahman, Tanni, et al., 2023), hospitals (Abir et al., 2021). However, no study has been conducted assessing the KAP level among university students in Bangladesh.

This study aimed to assess the knowledge, attitude and preventive practices among university students and influencing factors of good knowledge, good attitude and good practice. The outcome of our study can assist the government and non-governmental organizations, university authorities, and health and social workers in fostering holistic DF preparedness and response for university students of the city, which can ultimately contribute to reducing the DF outbreak across the country. It can also be integrated into the strategic plan to control infectious disease outbreaks, a fundamental issue for the national and international community.

Study design, area, and participant

A cross-sectional study was conducted between September 2023 to January 2024 among these university students. This cross-sectional study utilized a self-reported online survey to evaluate dengue responses through a KAP study among university students in Bangladesh. (Data collection universities are included in Online Resource 01.)

Sampling method

According to the Bangladesh Education Statistics, 2022 there are about 164 (public, private and international) educational institutions where total number of students were 1,034,320 ((BANBEIS), 2022). Participants were recruited using a non-probability sampling method through convenience sampling technique.

Sample size

The sample size was calculated using the following formula: n = z²pq/d²,

$$\:n=\frac{{z}^{2}pq}{{d}^{2}};n=\frac{{1.96}^{2}\:x\:0.68\:x\:(1-0.68)}{{0.05}^{2}}=334.37\:\approx\:335$$

here, n = total number of samples, z = the statistic that corresponds to the level of confidence = 1.96 (95% confidence level), p = a measure of expected prevalence, 68.32%, as there is a previous study in Bangladesh conducted among university students residing in Dhaka city (Rahman et al., 2022), q = (1-p), d = precession of the prevalence estimate (10% of 0.5) then the sample size was calculated as 335 subjects. A 10% non-response rate was taken into account while determining the optimal sample size of 370. However, to improve the external validity and generalizability of the research, 671 samples were taken than our estimated number (Cavana, Delahaye, & Sekeran, 2001).

Data collection tools and measurement

The structured questionnaire (in both native Bengali and English language) was developed in Google form after conducting literature reviews, adopted from previous studies (Hamid, 2023; Phuyal et al., 2022; Rahman et al., 2022). It had three sections with response items: socio-demographic and academic information; dengue infection history of their family members, neighbours and self-dengue infection history; and the final KAP section. Twenty-four questions were for knowledge (Yes/No), six for attitude (5-point Likert scale-based questions: Strongly agree, agree, neutral, disagree and strongly disagree), and twenty-one (Yes/No) for the preventive practices. Each correct answer counted as 1 score. The knowledge score ranged from 0–24 scores. The attitude toward dengue fever score ranged from 0–6 scores. The DF prevention practices score ranged from 0–21 scores. We calculated 80% cut-off scores for all sections of knowledge, attitude and practice and categorize them as “Good” and “Poor” levels in the KAP domain (Phuyal et al., 2022). (The KAP questions along with the response are included in Online Resource 01.)

Data collection strategy

A structured questionnaire (in both Bangla and English language) was used for data collection. The study authors distributed the Google form link to various institutions through different media applications (WhatsApp, Messenger) by contacting the class representatives.

A preliminary assessment was conducted with 25 participants from the designated population to evaluate the questionnaire’s acceptability and transparency and based on the pilot test results, minor modifications were made to the questionnaire. The initial page of the questionnaire included an informed consent statement that outlined the study’s objectives, procedures, and the participants' right to decline participation.

Statistical analysis

The obtained data were rechecked for completeness and consistency. (College Park, Texas) Microsoft Excel and STATA 17 software was used for data management and statistical analysis respectively. Shapiro–Wilk test were performed to check the normality of the data. Descriptive statistical analyses (frequency and percentage) were calculated along with the chi-square test of independence was used to test the association between demographic variables and knowledge, attitude and practice dependent variables. To check the multicollinearity of the variables, the variance influence factor (VIF) of the variables less than 2 were taken for multiple logistic regression analysis (Shrestha, 2020). Unadjusted (Crude odds ratio, COR) and adjusted logistic regression (Adjusted odds ratio, AOR) analysis were performed to determine the predictors of KAP level. All statistical analysis was performed at 0.05 α level and Hosmer-Lemeshow test was checked to certain the Goodness of fit of the logistic regression models.

In Table 1, the majority of the participants of this study were male (67.7%) and living with their family (59.5%). The majority of participants were from the Science and Engineering department/faculty/major (73.47%). A significant proportion of participants reported having dengue-relevant subject in their current curriculum (43.7%). Participants reported a history of dengue infection within the last six months (10.6%) and found dengue cases among household members (37.7%) and neighbourhood (69.75%).

Table 1

Socio-demographic information of participants (N = 671)
Variables		Frequency (n)	Percentage (%)
Gender	Male	454	67.7
Gender	Female	217	32.3
Living with family	Yes	399	59.5
Living with family	No	272	40.5
Department/ Faculty/ Major	Arts and Social Sciences	148	22.1
	Business Studies	30	4.5
	Science and Engineering	493	73.5
Dengue-relevant subject in the current curriculum	Yes	293	43.7
Dengue-relevant subject in the current curriculum	No	378	56.3
Heard about dengue	Yes	637	94.9
Heard about dengue	No	34	5.1
Dengue infection history in last six months	Yes	71	89.4
Dengue infection history in last six months	No	600	10.6
House members infected with dengue in last six months	Yes	253	37.7
House members infected with dengue in last six months	No	418	62.3
Neighbours infected with dengue in last six months	Yes	468	69.8
Neighbours infected with dengue in last six months	No	203	30.3

Table 2 depicts the overall score of knowledge attitude and practice level where 30.4% of university students had good knowledge on DF and 35.9% had good practice level on DF in spite of having higher attitude level (72.3%).

Table 2

Overall score of knowledge attitude and practice level
Characteristics	Score level	n	%
Knowledge	Low score	467	69.6
Knowledge	High score	204	30.4
Attitude	Low score	186	27.7
Attitude	High score	485	72.3
Practice	Low score	430	64.1
Practice	High score	241	35.9

Table 3 illustrates the association between socio-demographic factors with dengue knowledge, attitudes and preventive practices (KAP). Dengue knowledge levels were significantly associated with the students' year of study (p = 0.006), inclusion of dengue-related subjects in the curriculum (p = 0.001), awareness of dengue (p = 0.003), and having neighbours who experienced dengue cases (p = 0.009). Positive attitudes towards dengue prevention were higher among males (p = 0.029) and attitude was significantly associated among participants having dengue-related subjects in the current curriculum (p = 0.022). Significant associations in dengue prevention practices were found among participants who had dengue cases among family members (p = 0.004), and neighbours (p = 0.001).

Table 3

Association between socio-demographic factors and dengue knowledge, attitudes and preventive practices (N = 671)
Characteristics	knowledge		p value	attitude		p value	practice		p value
Gender	High knowledge n (%)	Low knowledge n (%)	p value	High knowledge n (%)	Low knowledge n (%)	p value	High knowledge n (%)	Low knowledge n (%)	p value
Male	130 (28.6)	324 (71.4)	0.15	340 (74.9)	114 (25.1)	0.029	156 (34.4)	298 (65.6)	0.224
Female	74 (34.1)	143 (65.9)	0.15	145 (66.8)	72 (33.2)	0.029	85 (39.2)	132 (60.8)	0.224
Living with family
Yes	87 (32.0)	185 (68.0)	0.462	193 (71.0)	79 (29.0)	0.527	105 (38.6)	167 (61.4)	0.231
No	117 (29.3)	282 (70.7)	0.462	292 (73.2)	107 (26.8)	0.527	136 (34.1)	263 (65.9)	0.231
Department/ Faculty/ Major
Arts and Social Sciences	45 (30.4)	103 (69.6)	0.9	102 (68.9)	46 (31.1)	0.269	52 (35.1)	96 (64.9)	0.524
Business Studies	8 (26.7)	22 (73.3)		19 (63.3)	11 (36.7)		8 (26.7)	22 (73.3)
Science and Engineering	151 (30.6)	342 (69.4)		364 (73.8)	129 (26.2)		181 (36.7)	312 (63.3)
Dengue-relevant subject in the current curriculum
Yes	109 (37.2)	184 (62.8)	0.001	225 (76.8)	68 (23.2)	0.022	109 (37.2)	184 (62.8)		0.541
No	95 (25.1)	283 (74.9)	0.001	260 (68.8)	118 (31.2)	0.022	132 (34.9)	246 (65.1)		0.541
Heard about dengue
Yes	186 (29.2)	451 (70.8)	0.003	460 (72.2)	177 (27.8)	0.867	231 (36.3)	406 (63.7)	0.417
No	18 (52.9)	16 (47.1)	0.003	25 (73.5)	9 (26.5)	0.867	10 (29.4)	24 (70.6)	0.417
Dengue infection history in last six months
Yes	21 (29.6)	50 (70.4)	0.873	55 (77.5)	16 (22.5)	0.302	23 (32.4)	48 (67.6)	0.513
No	183 (30.5)	417 (69.5)	0.873	430 (71.7)	170 (28.3)	0.302	218 (36.3)	382 (63.7)	0.513
House members infected with dengue in last six months
Yes	76 (30.6)	177 (69.4)	0.874	193 (76.3)	60 (23.7)	0.071	108 (42.7)	145 (57.3)	0.004
No	128 (30.0)	290 (70.0)	0.874	292 (69.9)	126 (30.1)	0.071	133 (31.8)	285 (68.2)	0.004
Neighbours infected with dengue in last six months
Yes	76 (37.4)	127 (62.6)	0.009	157 (77.3)	46 (22.7)	0.054	54 (26.6)	149 (73.4)	0.001
No	128 (27.4)	340 (72.7)	0.009	328 (70.1)	140 (29.9)	0.054	187 (40.0)	281 (60.0)	0.001

The multiple logistic regression analysis in Table 4 depicts that having a dengue-related subject in the current curriculum was found to be a significant predictor of good knowledge, with an adjusted odds ratio of 1.63 (95% CI 1.16–2.29, p = 0.005). Additionally, the occurrence of dengue cases among neighbours was associated with an increase in dengue fever knowledge among students (OR: 1.55, 95% CI 1.06–2.27, p = 0.022).

Table 4

Logistic regression analysis of knowledge towards dengue fever among university students (N = 671)
Characteristics		knowledge		knowledge
		COR* (95% *CI)	p value	AOR* (95% *CI)	p value
Gender	Male	ref		ref
	Female	1.29 (0.91–1.82)	0.150	1.18 (0.83–1.69)	0.358
University type	Private	ref		ref
	Public	0.74 (0.47–1.16)	0.188	0.65 (0.40–1.04)	0.075
Dengue-relevant subject in the current curriculum	No	ref		ref
	Yes	1.76 (1.27–2.46)	0.001	1.63 (1.16–2.29)	0.005
Neighbors infected with dengue in last six months	No	ref		ref
	Yes	1.58 (1.12–2.25)	0.009	1.55 (1.06–2.27)	0.022

COR- Crude odds ratio; AOR- Adjusted odds ratio; *CI: confidence intervals

The multiple logistic regression analysis in Table 5 shows that, male participants had higher odds of good attitude level on DF than the female counterparts (OR:0.67, 95%CI: 0.47–0.95, p value = 0.026). In addition, participants who had dengue related subject were found to have partially significant attitude level, in adjusted model (AOR:1.44, CI 1.01–2.07, p = 0.043).

Table 5

Logistic regression analysis of attitude towards dengue fever among university students (N = 671)
Characteristics		Attitude			Attitude
		COR* (95% *CI)	p value		AOR* (95% *CI)	p value
Gender	Male	ref			ref
	Female	0.68 (0.47–0.96)		0.029	0.67 (0.47–0.95)		0.026
Residential unit	Mixed	ref			ref
	High rise	1.68 (1.02–2.78)		0.042	1.53 (0.92–2.54)		0.103
	Low rise	0.28 (0.83–1.97)		0.26	1.21 (0.78–1.87)		0.388
Dengue-relevant subject in the current curriculum	No	ref			ref
	Yes	1.50 (1.06–2.13)		0.022	1.44 (1.01–2.06)		0.043
House members infected with dengue in last six months	No	ref			ref
	Yes	1.39 (0.97–1.98)		0.072	1.39 (0.97–2.00)		0.076

COR- Crude odds ratio; AOR- Adjusted odds ratio; *CI: confidence interval

The multiple logistic regression analysis in Table 6 illustrates that participants who had dengue case/es among their family members had developed preventive practices 1.65 (95% CI: 1.18–2.29, p = 0.003) times more than who didn’t. Additionally, participants were less likely to adopt dengue preventive practices when they encountered dengue cases in their neighbourhood (OR: 0.51, 95% CI: 0.35–0.75, p = 0.001).

Table 6

Logistic regression analysis of practices towards dengue fever among university students (N = 671)
Characteristics		Practice			Practice
		COR* (95% *CI)	p value		AOR* (95% *CI)	p value
Gender	Male	ref			ref
	Female	1.23 (0.88–1.72)		0.225	1.29 (0.91–1.84)		0.151
Living with family	No	ref			ref
	Yes	1.22 (0.88–1.67)		0.231	1.28 (0.80–1.58)		0.489
University type	Private	ref			ref
	Public	0.74 (0.47–1.14)		0.170	1.05 (0.66–1.67)		0.843
House members infected with dengue in last six months	No	ref			ref
	Yes	1.60 (1.16–2.20)		0.005	1.65 (1.18–2.29)		0.003
Neighbors infected with dengue in last six months	No	ref			ref
	Yes	0.54(0.38–0.78)		0.001	0.51 (0.35–0.75)		0.001

COR- Crude odds ratio; AOR- Adjusted odds ratio; *CI: confidence intervals

Table 7 depicts that higher odd of preventive practices (OR, 1.75; 95% CI: 1.25–2.46) were found to be significantly associated with high knowledge level among university students. Moreover, partial significant association of preventive practices (OR: 1.47; 95% CI: 1.47–2.16) was found among participants with good level of attitude.

Table 7

Bivariate association of dengue knowledge, attitude and practice
Characteristics	OR (95% CI)	p value
Knowledge – Practice	1.75 (1.25–2.46)	0.001
Attitude – Practice	1.02 (0.72–1.46)	0.855
Knowledge – Attitude	1.47 (1.0–2.16)	0.049

OR- Odds ratio; CI: confidence intervals

This study delves into the knowledge, attitude and prevention practices towards DF, among university students of Bangladesh. According to our study, a small proportion of the students (30.4%) achieved a high knowledge score. This finding was lower than the studies conducted in India(Arora, Arora, Sharma, & Kotwal, 2017), Pakistan(Itrat et al., 2008), Malaysia (Naing et al., 2011), Brazil (Dégallier, Vilarinhos, de Carvalho, Knox, & Caetano, 2000), Jamaica (Shuaib, Todd, Campbell-Stennett, Ehiri, & Jolly, 2010). The variation may be attributed to the presence of DF awareness, varying research sites, methodologies, and sample sizes. However, study conducted among university students in Dhaka city (Rahman et al., 2022) in 2021 had higher knowledge score (66.72%) on DF. Lower level of knowledge score after this year gaps in 2024, is a matter of concern for this vulnerable group.

Students in our study were found to obtain high attitude score (72.28%) indicates a greater concern of the participants towards DF. This result is concordant with other studies conducted in Yemen (Saied et al., 2015), Nepal (Phuyal et al., 2022), Malaysia (Lugova & Wallis, 2017) and among university students in Dhaka city. This elevated level of concern may stem from increased exposure to information about DF and its risks through various sources, such as educational institutions, social media, and the transmission of news and information from television channels.

35.92% participants of our study reported a high practice score which is found consistent with studies conducted in Jamaica (Shuaib et al., 2010), Nepal (Phuyal et al., 2022), Indonesia (Harapan et al., 2018). However, this finding was lower than a study conducted among university students in Malaysia (Lugova & Wallis, 2017). The possible explanation might be that the students do not believe they are at danger of developing DF which may have contributed to this. A person's behaviour is strongly rooted in structural and social variables, making transformation difficult, (Phuyal et al., 2022) such as sleeping outdoors due to load shedding, absence or unable to bear mosquito control materials like mosquito coils, spray, repellent cream or ointments etc.

Students having dengue related subject in their current curriculum were significantly associated with higher knowledge and attitude. The finding was in accordance with prior studies carried out among students and youth in Dhaka city(Rahman et al., 2022; A. Siddique et al., 2024) and in consistent with a study conducted in Riohacha, Colombia(Benítez-Díaz, Diaz-Quijano, & Martínez-Vega, 2020). A potential reason might be that it is education which brings behavioural changes among students resulting in change in attitude. Moreover, university students possess higher health literacy which enables them to face challenges against dengue and protect themselves(Benítez-Díaz et al., 2020). University authorities could play a crucial role in health promotion so that they can contribute in raising awareness among this vulnerable group. Moreover, to implement long-term dengue prevention habits, education and monitoring should continue (M. I. Hossain et al., 2021).

Our study reveals that dengue cases in neighbourhood were an influencing factor for participants enhancing their knowledge level on dengue fever. This result ties nicely with prior studies conducted in Bangladesh(A. Siddique et al., 2024), Portugal(Nazareth et al., 2015) and Colombia(Benítez-Díaz et al., 2020). The possible explanation might be that individuals who have personally encountered dengue or who have close connections with those affected by the disease are more likely to perceive an increased risk of dengue fever which influence one to gain more knowledge on dengue fever and its consequences.

Attitude level was found to be lower among female compared to male participants. The findings contrasted with those of other studies conducted in Malaysia(Wong, Shakir, Atefi, & AbuBakar, 2015) and Puerto Rico (Pérez-Guerra, Zielinski-Gutierrez, Vargas-Torres, & Clark, 2009). This discrepancy may be due to the lower number of female participants in this study, which could have resulted in a lower overall attitude level.

Our study found a significant association between preventive practices and students who had family members affected by dengue. This result aligns with findings from other studies conducted in Costa Rica (Egedus, Ortega, & Obando, 2014), Pakistan (Itrat et al., 2008), Venezuela (Elsinga et al., 2018). A plausible rationale might be that respondents with household dengue infection/s may view dengue as more threatening and prioritize prevention. This heightened awareness of dengue symptoms and preventive practices within families may increase the likelihood of preventing dengue fever.

The present study found a significant association between a high level of knowledge and the adoption of effective dengue-related preventive practices among participants. These finding lines up with previous research, which has consistently demonstrated a positive correlation between dengue knowledge and the implementation of prevention and control measures (Itrat et al., 2008; Lugova & Wallis, 2017; Wong et al., 2015). A plausible explanation for this relationship is that greater knowledge of the dengue virus may lead to behavioural changes among students, fostering an increased commitment to preventive practices. Enhanced awareness of the symptoms, transmission methods, and preventive strategies for dengue likely contributes to improved compliance with these practices, ultimately aiding in the prevention and control of the disease.

Limitations and strengths

The use of a convenience sampling technique and reliance on a self-reported online survey may introduce bias. Additionally, data collected through offline surveys using questionnaires could be biased, as students might influence each other's responses to certain questions. Furthermore, no follow-up investigation or observation was conducted for students who reported not being at risk for dengue. Those who were infected with dengue fever were not asked if they had reports of their infection.

As no other study has been conducted, the findings of this study can help to gain a deep understanding on the student's KAP on DF. The data can also help researchers study future dengue conditions in comparing with the findings of this study.

Overall knowledge and practice level were considerably lower among university students however the attitude level was high. Based on the findings of this study, awareness regarding dengue fever should be created among university students. In addition, knowledge and attitude should be converted to preventable practices among these vulnerable groups.

Author’s contributions

Nasimul Ghani Usmani, Role: Writing – Methodology, Data curation, Formal analysis, Original draft.

Md. Hafizur Rahman, Pradip Chandra, Role: Methodology, Writing – Review and Editing

Md. Hasanuzzaman, Md. Asaduzzaman Miah, Md. Nazmul Hassan, Role: Writing – Review and Editing, Visualization.

Tamanna Hassan, Sourav Chandra Debnath, Md. Bony Amin, Role: Data curation, Writing – Review and Editing.

Sunjida Munmun, Sirajul Islam Pial, Role: Writing – Review and Editing.

Funding

'Not applicable'

Conflicts of interest

'Not applicable'

Ethics approval

Informed consent was obtained from all participants. Prior to the interview, consent was obtained following the ethical guidelines of the WHO and the Bangladesh Medical Research Council (BMRC). Research Ethical Committee (REC) of the Department of Environmental Sanitation, Patuakhali Science and Technology University, Bangladesh (approval no.: PSTU/IEC/2023/72) reviewed the protocol and approved this study.

Consent to participate

Prior to the start of the data collection, informed consent was obtained from the participants, detailing the study's objectives, procedures, and their right to refuse participation.

Consent for publication

Prior to the start of the data collection, informed consent was obtained from the participants, detailing the publication of the study based on their data.

Availability of data and material

Data files may be shared upon reasonable requests.

Code availability

Codes may be shared upon reasonable requests.

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The authors declare no competing interests.

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Knowledge, Attitude, and Practices towards Dengue Fever among University Students in Bangladesh: a cross-sectional study

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Abstract

Introduction

Methods

Study design, area, and participant

Sampling method

Sample size

Data collection tools and measurement

Data collection strategy

Statistical analysis

Result

COR- Crude odds ratio; AOR- Adjusted odds ratio; *CI: confidence intervals

COR- Crude odds ratio; AOR- Adjusted odds ratio; *CI: confidence interval

COR- Crude odds ratio; AOR- Adjusted odds ratio; *CI: confidence intervals

OR- Odds ratio; CI: confidence intervals

Discussion

Limitations and strengths

Conclusion

Declarations

References

Additional Declarations

Supplementary Files

Status:

Version 1

Knowledge, Attitude, and Practices towards Dengue Fever among University Students in Bangladesh: a cross-sectional study

Status:

Version 1

Abstract

Introduction

Methods

Study design, area, and participant

Sampling method

Sample size

Data collection tools and measurement

Data collection strategy

Statistical analysis

Result

*COR- Crude odds ratio; *AOR- Adjusted odds ratio; *CI: confidence intervals

*COR- Crude odds ratio; *AOR- Adjusted odds ratio; *CI: confidence interval

*COR- Crude odds ratio; *AOR- Adjusted odds ratio; *CI: confidence intervals

*OR- Odds ratio; *CI: confidence intervals

Discussion

Limitations and strengths

Conclusion

Declarations

References

Additional Declarations

Supplementary Files

Status:

Version 1

COR- Crude odds ratio; AOR- Adjusted odds ratio; *CI: confidence intervals

COR- Crude odds ratio; AOR- Adjusted odds ratio; *CI: confidence interval

COR- Crude odds ratio; AOR- Adjusted odds ratio; *CI: confidence intervals

OR- Odds ratio; CI: confidence intervals