Socioeconomic, Demographic, and Behavioral Factors Associated with Dengue Outbreak: An Observational Study from Eastern Uttar Pradesh, India.

Abstract

Background: Clinical and epidemiological aspects of dengue have extensively been studied in India. However, limited data are available on social and behavioral aspects of dengue outbreak. We aimed to fill this gap and wish to study socioeconomic, demographic, and behavioral factors associated with dengue outbreak in the Gorakhpur region of eastern Uttar Pradesh, India. Methods: This retrospective observational study was conducted among dengue patients discharged from hospital. Data on sociodemographic, economic, and behavioral factors of dengue were collected telephonically using a structured questionnaire. Continuous and categorical variables were reported as mean ± SD and numbers (%), respectively. Logistic regression analysis was done to establish association between patient's characteristics, awareness, and preventive behavior. Results: Age group 19-45 years 156/232, males 159/232, urban residents 142/232, residing in pucca house 187/232, and from lower-income families 149/232 were mostly affected in this outbreak. Patients spent a median of Indian national rupees 20,000 on treatment. Only 10.8% of patients had Ayushman health insurance cards. Awareness about dengue infection was found in∼43% patients. Literates, middle income group, and professionals/semiprofessionals were significantly more aware about dengue disease, mosquito bite, and treatment than their counterparts. Travel history was significantly associated with dengue infection in the males of 19-45 years age group belonging to rural areas. Use of mosquito repellent, nets, wearing full sleeve clothes were significantly less in rural residents while barefoot walking was more frequently observed in this population. Use of mosquito repellent was significantly associated with income, and these were observed more in the middle-income group. Conclusion: People with low education level, residing in urban areas, residing in pucca houses, who travel frequently, and who belong to lower-income groups were majorly affected by this dengue outbreak. Less dengue awareness and not following preventive practices were found in them. Targeted health education campaigns in urban setting could prevent dengue and economic burden on these vulnerable groups.