Vector-borne diseases, notably dengue, malaria, and chikungunya, remain significant public health challenges globally, particularly within tropical and subtropical regions. In India, these diseases collectively contribute substantially to morbidity and mortality, thereby straining healthcare resources and negatively impacting economic productivity and quality of life.^1,2 Haryana, a rapidly urbanizing and developing state in North India, is especially vulnerable to periodic outbreaks and sustained transmission of these vector-borne diseases due to factors such as increasing urban population density, climatic changes, inadequate sanitation infrastructure, and limited community awareness.^3-5

Public awareness and preventive measures form the foundation of effective control and management of vector-borne diseases. Enhanced knowledge about disease transmission pathways, vector ecology, personal and community-level preventive practices, and prompt recognition of symptoms significantly contributes to reducing the incidence and severity of these infections. Despite various interventions by governmental and non-governmental organizations aimed at raising public awareness, considerable gaps remain between public knowledge and the implementation of preventive practices among communities in Haryana.^1,6,7

The present study seeks to critically evaluate the current levels of public awareness regarding dengue, malaria, and chikungunya in Haryana, alongside assessing preventive measures practiced by local communities. By identifying existing knowledge gaps and behavioral practices, this research aims to recommend targeted strategies for improved public health education, preventive behaviors, and community engagement. The findings of this study are expected to provide valuable insights for policymakers, health practitioners, and community stakeholders, ultimately aiding in the formulation of effective strategies to mitigate the impact of vector-borne diseases in Haryana and similar regional contexts.

Study Area

The study was conducted across selected districts of Haryana, a state in North India characterized by rapid urbanization, diverse socioeconomic conditions, and a variable pattern of disease transmission dynamics. Haryana was selected due to its historical susceptibility to outbreaks of vector-borne diseases, including dengue, malaria, and chikungunya, making it an ideal representative setting to assess public awareness and preventive practices.

Study Design and Sampling Technique

A descriptive cross-sectional study design was adopted to assess public awareness and preventive behaviors concerning dengue, malaria, and chikungunya. Multistage sampling was employed to ensure representativeness across both urban and rural settings. Initially, districts were selected purposively based on historical disease incidence and demographic diversity. Within these districts, stratified random sampling was used to identify specific urban wards and rural villages, ensuring proportionate representation across different demographic segments.

Study Population and Sample Size

The target population included adults aged 18 years and above, residing in the selected districts of Haryana for at least one year. The sample size was calculated using the standard formula for cross-sectional studies, assuming an estimated prevalence of adequate public awareness at 50%, a confidence interval of 95%, and a margin of error of ±5%. An additional 10% was added to compensate for non-response and incomplete data. The final sample size encompassed approximately 400 respondents, evenly distributed between urban and rural locations to facilitate comparative analysis.

Data Collection Tool

A structured questionnaire was developed and validated through expert consultation and pre-testing among a small subset of the study population. The questionnaire comprised four main sections:

1. Socio-demographic characteristics (age, gender, education, occupation, income).
2. Knowledge regarding dengue, malaria, and chikungunya (transmission, symptoms, vector ecology).
3. Preventive measures and practices undertaken by respondents at individual and household levels.
4. Sources of information and awareness campaigns effectiveness.

Questions were designed in both English and local languages (Hindi and Haryanvi dialect) to ensure clarity and accuracy in response.

Data Collection Procedure

Face-to-face interviews were conducted by trained field investigators after obtaining informed consent from each participant. Interviews lasted approximately 15–20 minutes each and were conducted in the local language, ensuring maximum comprehension and accurate response collection. To enhance data quality, regular field supervision and spot-checks were conducted by the principal investigator.

Ethical Considerations

Ethical clearance was obtained from the Institutional Ethics Committee prior to data collection. Confidentiality and anonymity of participants were strictly maintained. Participants were informed about the study’s purpose, their right to withdraw at any time, and assurance that their responses would be used solely for research purposes.

Statistical Analysis

Data were entered and analyzed using SPSS (Statistical Package for Social Sciences), version 25.0. Descriptive statistics (frequency distribution, mean, standard deviation) were used to summarize socio-demographic characteristics, knowledge levels, and preventive practices. Chi-square tests were employed to examine associations between categorical variables such as education level, residence type (urban vs rural), and preventive practices. Logistic regression analysis was conducted to identify predictors of adequate knowledge and preventive behavior. Statistical significance was set at p<0.05.

Of the total 400 respondents, slightly more than half (54%) were males, while females accounted for 46%. The majority of respondents (38%) belonged to the age group of 31–45 years, followed by 18–30 years (33%). Educationally, the highest proportion had completed secondary education (39%), while 25% were graduates or above, 21% had primary education, and 15% were illiterate. The sample was evenly divided between urban and rural residents, each comprising 50% of the total.

Table 1: Socio-demographic Characteristics of Respondents (n=400)

Respondents demonstrated varied levels of knowledge concerning vector-borne diseases. While a majority (78%) correctly identified the mode of transmission, awareness regarding symptom recognition was relatively lower (69%). Knowledge about vector breeding sites was moderate (59%), whereas only about half the respondents (52%) were aware of specific preventive measures. The lowest awareness (45%) was observed regarding the peak season for disease transmission.

Table 2: Knowledge Level about Dengue, Malaria, and Chikungunya (n=400)

Television and radio emerged as the predominant sources of information on vector-borne diseases, cited by 72% of respondents, followed by newspapers (55%). Health professionals provided information to 48% of respondents, while community awareness campaigns reached 42%. Social media was utilized by 38%, indicating its growing but moderate role in disseminating health information.

Table 3: Sources of Information (Multiple responses allowed)

The most widely practiced preventive measure was the use of mosquito repellents or coils (62%), followed by regular household sanitation activities such as eliminating stagnant water (55%). Nearly half of respondents (49%) used mosquito nets regularly, and 43% preferred wearing protective clothing. Installation of window screens or mesh was the least practiced method, adopted by only 35% of respondents.

Table 4: Preventive Practices among Respondents (n=400)

Significant associations were observed between respondents' knowledge levels and several socio-demographic factors. Adequate knowledge was significantly higher among urban residents (p=0.003) and respondents with higher educational qualifications (p=0.001). However, no significant associations were found with gender (p=0.490) or age groups (p=0.173), suggesting that knowledge dissemination efforts should particularly focus on rural areas and less educated populations.

Table 5: Association between Knowledge Level and Socio-demographic Variables (n=400)

Preventive practices were significantly associated with gender (p=0.031), residence (p<0.001), and educational status (p<0.001). Females practiced preventive behaviors more frequently than males. Urban residents and those with higher educational qualifications also adopted preventive measures more consistently. Age did not exhibit a significant relationship with the level of preventive practice (p=0.298).

Table 6: Association between Preventive Practices and Socio-demographic Variables (n=400)

Logistic regression analysis indicated urban residence (Adjusted OR=2.10; 95% CI: 1.32–3.32, p=0.001) and higher educational attainment (Adjusted OR=2.56; 95% CI: 1.58–4.14, p<0.001) as significant predictors of adequate knowledge about vector-borne diseases. However, age (Adjusted OR=1.22; 95% CI: 0.78–1.90, p=0.382) and gender (Adjusted OR=0.95; 95% CI: 0.62–1.44, p=0.812) were not significant predictors in the adjusted analysis.

Table 7: Logistic Regression Analysis of Factors Influencing Adequate Knowledge

Preventive practice adoption was strongly influenced by urban residence (Adjusted OR=2.12; 95% CI: 1.40–3.20, p<0.001) and higher educational levels (Adjusted OR=2.42; 95% CI: 1.54–3.80, p<0.001). Age group (>30 years) showed borderline significance (Adjusted OR=1.45; 95% CI: 0.94–2.24, p=0.085), whereas female gender was not statistically significant after adjustment (Adjusted OR=1.30; 95% CI: 0.86–1.95, p=0.210). This highlights the need to reinforce preventive practices, particularly among rural and less educated populations.

Table 8: Logistic Regression Analysis of Factors Influencing Preventive Practices

This study systematically assessed public awareness and preventive practices regarding dengue, malaria, and chikungunya among residents of Haryana, a region prone to vector-borne disease outbreaks due to rapid urbanization, socioeconomic variability, and infrastructural gaps. Our findings highlight critical gaps in community awareness about vector-borne diseases, particularly related to symptoms, transmission cycles, breeding sites, and effective prevention methods. These gaps persist despite ongoing governmental and community health initiatives, suggesting a need to revisit existing public health strategies and communication methods.

The results indicated substantial variation in awareness and preventive behaviors based on socio-demographic characteristics. Educational status emerged as a strong predictor, significantly influencing both knowledge and preventive actions. Individuals with secondary and higher education exhibited greater awareness and implemented preventive practices more consistently compared to those with primary or no formal education. This observation aligns with previous studies that consistently underline the importance of education in fostering health literacy, critical thinking, and adherence to recommended preventive practices.^8-10

Urban residents showed significantly higher levels of awareness and better preventive behavior compared to their rural counterparts. This disparity could be attributed to improved access to information sources, healthcare services, and greater availability of resources necessary for disease prevention in urban settings. Previous research supports this finding, emphasizing urban-rural differences due to differential allocation of health resources, infrastructural amenities, and targeted public health campaigns. Consequently, rural populations remain disproportionately vulnerable and represent critical targets for intensified public health interventions.^8,11,12

Gender was found to have an interesting relationship with preventive practices. Although overall knowledge levels did not differ significantly between males and females, women were more proactive in adopting preventive measures. This gender difference likely reflects women's traditional roles within households as primary caregivers, thus enhancing their commitment to preventive health behaviors for family safety. Age exhibited an inconsistent association, with older respondents demonstrating slightly better preventive practices, possibly driven by higher perceived vulnerability or past experiences with these diseases. However, age was not a strong predictor of knowledge, suggesting that awareness campaigns should engage all age groups equally but could leverage higher preventive motivation among older populations.^13-16

Television, radio, and newspapers were identified as the most influential sources of information. This finding underscores the continued efficacy of traditional mass media in disseminating health education widely. However, the modest influence of healthcare professionals and community-based campaigns indicates untapped opportunities for improvement. Given the personal credibility of health professionals and the potential for interactive community engagement, enhancing these channels could significantly strengthen public awareness and preventive practices. Moreover, social media platforms, currently underutilized according to the study findings, present promising avenues to target younger demographics effectively and should be integrated systematically into broader health communication strategies.^17-19

Logistic regression analyses further confirmed the influence of education and urban residency as robust predictors for adequate knowledge and preventive behaviors. These predictors remained significant even after adjusting for other factors, indicating their independent influence on health literacy and action. The observed borderline significance for age and the non-significant association with gender in adjusted analyses reinforce the need for broader, inclusive public health interventions rather than narrowly targeted ones based solely on age or gender demographics.^19-21

This study highlights persistent knowledge gaps and suboptimal preventive practices among residents of Haryana, largely influenced by educational and residential disparities. It suggests that comprehensive, tailored, and context-specific interventions addressing rural populations, educationally disadvantaged groups, and leveraging trusted information sources like mass media, healthcare professionals, and community campaigns are urgently needed. These findings provide crucial evidence for policymakers and public health practitioners to strategically reorient public health education programs, ensuring sustained community engagement and resilience against dengue, malaria, and chikungunya in Haryana and similar epidemiological settings.

The study underscores significant gaps in public awareness and preventive practices concerning dengue, malaria, and chikungunya in Haryana, primarily influenced by educational disparities and urban-rural residence. Targeted public health interventions emphasizing rural populations, education enhancement, and effective utilization of mass media, health professionals, and community campaigns are essential. Strengthening community-based educational initiatives and infrastructure support can significantly improve health literacy, encourage preventive behaviors, and ultimately reduce the burden of vector-borne diseases in Haryana and similar contexts.

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