Castro Marta, Sánchez Lizet, Pérez Dennis, Sebrango Carlos, Shkedy Ziv, Van der Stuyft Patrick
Epidemiology Division, Institute of Tropical Medicine "Pedro Kouri", Havana, Cuba.
Clinical Research Direction, Center of Molecular Immunology, Havana, Cuba.
PLoS One. 2013 Dec 12;8(12):e81875. doi: 10.1371/journal.pone.0081875. eCollection 2013.
The reemergence of dengue as an important public health problem reflects the difficulties in sustaining vertically organized, effective, control programs and the need for community-based strategies for Aedes aegypti control that result in behavioral change. We aimed to disentangle the relationships between underlying determinants of dengue related practices. We conducted a cross-sectional study in 780 households in La Lisa, Havana, Cuba. A questionnaire and an observation guide were administrated to collect information on variables related to economic status, knowledge on dengue, risk perception and practices associated with Aedes aegypti breading sites. To test a conceptual model that hypothesized direct relationships among all these constructs, we first used Exploratory Factor Analysis with Principal Component Analysis to establish the relationship between observed variables and the underlying latent variables. Subsequently, we tested whether the observed data supported the conceptual model through Confirmatory Factor Analysis. Exploratory Factor Analysis indicated that the items measured could be reduced into five factors with an eigenvalue >1.0: Knowledge on dengue, Intradomiciliar risk practices, Peridomiciliar risk practices, Risk perception and Economic status. The proportion of the total variance in the data explained by these five factors was 74.3%. The Confirmatory Factor Analysis model differed from our hypothesized conceptual model. Only Knowledge on dengue had a significant, direct, positive, effect on Practices. There was also a direct association of Economic status with Knowledge on dengue, but not with Risk perception and Practices. Clarifying the relationship between direct and indirect determinants of dengue related practices contributes to a better understanding of the potential effect of Information Education and Communication on practices and on the reduction of Aedes aegypti breeding sites and provides inputs for designing a community based strategy for dengue control.
登革热再度成为一个重要的公共卫生问题，这反映出维持垂直组织的有效防控项目存在困难，以及需要采取基于社区的策略来控制埃及伊蚊，从而改变人们的行为。我们旨在理清登革热相关行为的潜在决定因素之间的关系。我们在古巴哈瓦那的拉丽莎对780户家庭进行了一项横断面研究。通过一份问卷和一份观察指南来收集有关经济状况、登革热知识、风险认知以及与埃及伊蚊繁殖地相关行为的变量信息。为了检验一个假设所有这些构念之间存在直接关系的概念模型，我们首先使用主成分分析的探索性因子分析来确定观察变量与潜在潜变量之间的关系。随后，我们通过验证性因子分析来检验观察数据是否支持该概念模型。探索性因子分析表明，所测量的项目可以归结为五个特征值大于1.0的因子：登革热知识、室内风险行为、室外风险行为、风险认知和经济状况。这五个因子解释的数据总方差比例为74.3%。验证性因子分析模型与我们假设的概念模型不同。只有登革热知识对行为有显著、直接、正向的影响。经济状况也与登革热知识直接相关，但与风险认知和行为无关。理清登革热相关行为的直接和间接决定因素之间的关系，有助于更好地理解信息教育与沟通对行为以及减少埃及伊蚊繁殖地的潜在影响，并为设计基于社区的登革热防控策略提供依据。
