Barriers to Accessing Dengue Healthcare: A Multicenter Survey from Dhaka, a Major Dengue Hotspot in Bangladesh
-
MD NAHID HASSAN NISHAN
,
M Z E M Naser Uddin Ahmed
,
Sayeda Jahan Oishy
,
Aria Alam
,
Saidur Rahman Mashreky
Abstract
Abstract
Background
Dengue fever in Bangladesh, particularly in Dhaka, faces significant healthcare access barriers. Understanding these barriers is crucial for targeted interventions. Therefore, this study aims to analyze the barriers to accessing dengue healthcare through a multicenter survey in Dhaka, a major dengue hotspot in Bangladesh.
Methods
This cross-sectional study was employed throughout the study. The study was conducted in Dhaka City. this study used two-stage stratified sampling based on hospital type (public/private) and randomly selected 16 hospitals (7 public and 9 private), focusing on patients admitted with dengue. A total of 101 patients comprised the final sample.
Result
The study reveals overall 96.04% of participants perceived dengue as a serious threat. Demographically, the patients mostly lived in urban (85.15%) and varied in education. MANOVA indicates that demographic variables significantly impact access barriers, highlighting age, and education status as influential factors (P-value <0.05).
Conclusion
This study highlights the importance of age and education as key determinants of access barriers in dengue healthcare. Addressing the unique needs of children and older adults, as well as enhancing educational opportunities, could be pivotal in mitigating these barriers.
Reference
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19. Wilder-Smith A, Ooi EE, Horstick O, Wills B. Dengue. The Lancet [Internet]. 2019 Jan [cited 2024 Jul 16];393(10169):350–63. Available from: https://linkinghub.elsevier. com/retrieve/pii/S0140673618325601.
20. Tan Q, Hildon ZJL, Singh S, Jing J, Thein TL, Coker R, et al. Comparing patient and healthcare worker experiences during a dengue outbreak in Singapore: understanding the patient journey and the introduction of a point-of-care test (POCT) toward better care delivery. BMC Infect Dis [Internet]. 2017 Dec [cited 2024 Jul 16];17(1):503. Available from: http://bmcinfectdis.biomedcentral.com/ articles/10.1186/s12879-017-2580-9. 251 Vol 10 No 2 (2024) Barriers to Accessing Dengue Healthcare: A Multicenter Survey ... Nishan NH et al.
21. Selvarajoo S, Liew JWK, Tan W, Lim XY, Refai WF, Zaki RA, et al. Knowledge, attitude and practice on dengue prevention and dengue seroprevalence in a dengue hotspot in Malaysia: A cross-sectional study. Sci Rep [Internet]. 2020 Jun 12 [cited 2024 Jul 16];10(1):9534. Available from: https://www. nature.com/articles/s41598-020-66212-5.
22. Nikookar SH, Moosazadeh M, Fazeli Dinan M, Zaim M, Sedaghat MM, Enayati A. Knowledge, attitude, and practice of healthcare workers regarding dengue fever in Mazandaran Province, northern Iran. Front Public Health [Internet]. 2023 Jul 4 [cited 2024 Jul 16];11:1129056. Available from: https://www.frontiersin.org/articles/10.3389/ fpubh.2023.1129056/full.
23. Guad RM, Carandang RR, Solidum JN, W. Taylor-Robinson A, Wu YS, Aung YN, et al. Different domains of dengue research in the Philippines: A systematic review and meta analysis of questionnaire-based studies. Paz Bailey G, editor. PLoS ONE [Internet]. 2021 Dec 20 [cited 2024 Jul 16];16(12):e0261412. Available from: https://dx.plos.org/10.1371/ journal.pone.0261412.
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32. Mainuddin A, Ara Begum H, Rawal LB, Islam A, Shariful Islam SM. Women Empowerment and Its Relation with Health Seeking Behavior in Bangladesh. J Family Reprod Health. 2015 Jun;9(2):65–73.
33. Ahmed F, Oni FA, Hossen SS. Does gender inequality matter for access to and utilization of maternal healthcare services in Bangladesh? PLoS One. 2021;16(9):e0257388.
34. Worthington RP, Gogne A. Cultural aspects of primary healthcare in india: A case based analysis. Asia Pac Fam Med [Internet]. 2011 [cited 2024 Oct 24];10(1):8. Available from: http://apfmj.biomedcentral.com/ articles/10.1186/1447-056X-10-8.
35. Bhumkittipich P, Siramaneerat I, Iamsomboon N, Bhumkittipich K. Multiple Classification Analysis (MCA) of Key Factors Affecting Women’s Empowerment through health decision making in Remote Area of Thailand. Journal of Health Research [Internet]. 2024 Mar 1 [cited 2024 Oct 24];38(3). Available from: https://digital.car. chula.ac.th/jhr/vol38/iss3/4.
36. Krist AH, Tong ST, Aycock RA, Longo DR. Engaging Patients in Decision-Making and Behavior Change to Promote Prevention. Stud Health Technol Inform. 2017;240:284– 302.
37. Mahumud RA, Sarker AR, Sultana M, Islam Z, Khan J, Morton A. Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh. J Prev Med Public Health. 2017 Mar;50(2):91–9. 38. Rony MKK, Parvin MstR, Wahiduzzaman Md, Akter K, Ullah M. Challenges and Advancements in the Health Related Quality of Life of Older People. Zhang J, editor. Advances in Public Health [Internet]. 2024 Feb 1 [cited 2024 Oct 24];2024:1–18. Available from: https://www.hindawi.com/ journals/aph/2024/8839631/
1. Dengue and severe dengue [Internet]. [cited 2024 Jul 16]. Available from: https:// www.who.int/news-room/fact-sheets/detail/ dengue-and-severe-dengue.
2. Bashar K, Rahman MdS, Nodi IJ, Howlader AJ. Species composition and habitat characterization of mosquito (Diptera: Culicidae) larvae in semi-urban areas of Dhaka, Bangladesh. Pathogens and Global Health [Internet]. 2016 Feb 17 [cited 2024 Jul 16];110(2):48–61. Available from: http:// www.tandfonline.com/doi/full/10.1080/20477 724.2016.1179862.
3. Rahaman MA, Kalam A, Al-Mamun M. Unplanned urbanization and health risks of Dhaka City in Bangladesh: uncovering the associations between urban environment and public health. Front Public Health. 2023;11:1269362.
4. Da Silva AC, Scalize PS. Environmental Variables Related to Aedes aegypti Breeding Spots and the Occurrence of Arbovirus Diseases. Sustainability [Internet]. 2023 May 17 [cited 2024 Oct 23];15(10):8148. Available from: https://www.mdpi.com/2071- 1050/15/10/8148.
5. Sarfraz MS, Tripathi NK, Tipdecho T, Thongbu T, Kerdthong P, Souris M. Analyzing the spatio-temporal relationship between dengue vector larval density and land-use using factor analysis and spatial ring mapping. BMC Public Health [Internet]. 2012 Dec [cited 2024 Oct 23];12(1):853. Available from: https://bmcpublichealth.biomedcentral.com/ articles/10.1186/1471-2458-12-853.
6. Jahromi AS, Jokar M, Abdous A, Sharifi N, Abbasi T, Rahmanian V. Global systematic review and meta-analysis of knowledge, attitudes, and practices towards dengue fever among the general population. Asian Pacific Journal of Tropical Medicine [Internet]. 2024;17(5). Available from: https:// journals.lww.com/aptm/fulltext/2024/17050/ global_systematic_review_and_meta_ analysis_of.1.aspx.
7. Hossain MS, Noman AA, Mamun SAA, Mosabbir AA. Twenty-two years of dengue outbreaks in Bangladesh: epidemiology, clinical spectrum, serotypes, and future disease risks. Trop Med Health [Internet]. 2023 Jul 11 [cited 2024 Jul 16];51(1):37. Available from: https://tropmedhealth.biomedcentral.com/ articles/10.1186/s41182-023-00528-6.
8. Kayesh ME, Khalil I, Kohara M, Tsukiyama-Kohara K. Increasing Dengue Burden and Severe Dengue Risk in Bangladesh: An Overview. Tropical Medicine and Infectious Disease. 2023;8(1).
9. Dengue - Bangladesh [Internet]. [cited 2024 Jul 16]. Available from: https://www. who.int/emergencies/disease-outbreak-news/ item/2023-DON481.
10. Bhowmik KK, Ferdous J, Baral PK, Islam MS. Recent outbreak of dengue in Bangladesh: A threat to public health. Health 250 Vol 10 No 2 (2024) Barriers to Accessing Dengue Healthcare: A Multicenter Survey ... Nishan NH et al. Sci Rep. 2023 Apr;6(4):e1210.
11. Rahman MM, Tanni KN, Roy T, Islam MR, Al Raji Rumi MA, Sadman Sakib M, et al. Knowledge, Attitude and Practices Towards Dengue Fever Among Slum Dwellers: A Case Study in Dhaka City, Bangladesh. Int J Public Health. 2023;68:1605364.
12. Hossain MdI, Alam NE, Akter S, Suriea U, Aktar S, Shifat SK, et al. Knowledge, awareness and preventive practices of dengue outbreak in Bangladesh: A countrywide study. PLOS ONE [Internet]. 2021 Jun 10;16(6):e0252852. Available from: https:// doi.org/10.1371/journal.pone.0252852.
13. Abir T, Ekwudu O, Kalimullah NA, Nur-A Yazdani DM, Al Mamun A, Basak P, et al. Dengue in Dhaka, Bangladesh: Hospital based cross-sectional KAP assessment at Dhaka North and Dhaka South City Corporation area. PLoS One. 2021;16(3):e0249135.
14. Ng TC, Teo CH, Toh JY, Dunn AG, Ng CJ, Ang TF, et al. Factors influencing healthcare seeking in patients with dengue: Systematic review. Tropical Med Int Health [Internet]. 2022 Jan [cited 2024 Jul 16];27(1):13–27. Available from: https://onlinelibrary.wiley. com/doi/10.1111/tmi.13695.
15. The Financial Express [Internet]. [cited 2024 Oct 23]. Universal health coverage in Bangladesh: The challenges. Available from: https://thefinancialexpress.com.bd/ views/analysis/universal-health-coverage-in bangladesh-the-challenges-1549037007.
16. Weerasinghe NP, Bodinayake CK, Wijayaratne WMDGB, Devasiri IV, Dahanayake NJ, Kurukulasooriya MRP, et al. Direct and indirect costs for hospitalized patients with dengue in Southern Sri Lanka. BMC Health Serv Res [Internet]. 2022 Dec [cited 2024 Jul 16];22(1):657. Available from: https://bmchealthservres.biomedcentral.com/ articles/10.1186/s12913-022-08048-5.
17. Sarker AR, Paul S, Zohara F, Hossain Z, Zabeen I, Chowdhury SMZI, et al. Economic burden of dengue in urban Bangladesh: A societal perspective. Lenhart A, editor. PLoS Negl Trop Dis [Internet]. 2023 Dec 5 [cited 2024 Jul 16];17(12):e0011820. Available from: https://dx.plos.org/10.1371/journal. pntd.0011820.
18. CDC. Dengue. 2024 [cited 2024 Jul 16]. Clinical Care of Dengue. Available from: https://www.cdc.gov/dengue/hcp/clinical care/index.html.
19. Wilder-Smith A, Ooi EE, Horstick O, Wills B. Dengue. The Lancet [Internet]. 2019 Jan [cited 2024 Jul 16];393(10169):350–63. Available from: https://linkinghub.elsevier. com/retrieve/pii/S0140673618325601.
20. Tan Q, Hildon ZJL, Singh S, Jing J, Thein TL, Coker R, et al. Comparing patient and healthcare worker experiences during a dengue outbreak in Singapore: understanding the patient journey and the introduction of a point-of-care test (POCT) toward better care delivery. BMC Infect Dis [Internet]. 2017 Dec [cited 2024 Jul 16];17(1):503. Available from: http://bmcinfectdis.biomedcentral.com/ articles/10.1186/s12879-017-2580-9. 251 Vol 10 No 2 (2024) Barriers to Accessing Dengue Healthcare: A Multicenter Survey ... Nishan NH et al.
21. Selvarajoo S, Liew JWK, Tan W, Lim XY, Refai WF, Zaki RA, et al. Knowledge, attitude and practice on dengue prevention and dengue seroprevalence in a dengue hotspot in Malaysia: A cross-sectional study. Sci Rep [Internet]. 2020 Jun 12 [cited 2024 Jul 16];10(1):9534. Available from: https://www. nature.com/articles/s41598-020-66212-5.
22. Nikookar SH, Moosazadeh M, Fazeli Dinan M, Zaim M, Sedaghat MM, Enayati A. Knowledge, attitude, and practice of healthcare workers regarding dengue fever in Mazandaran Province, northern Iran. Front Public Health [Internet]. 2023 Jul 4 [cited 2024 Jul 16];11:1129056. Available from: https://www.frontiersin.org/articles/10.3389/ fpubh.2023.1129056/full.
23. Guad RM, Carandang RR, Solidum JN, W. Taylor-Robinson A, Wu YS, Aung YN, et al. Different domains of dengue research in the Philippines: A systematic review and meta analysis of questionnaire-based studies. Paz Bailey G, editor. PLoS ONE [Internet]. 2021 Dec 20 [cited 2024 Jul 16];16(12):e0261412. Available from: https://dx.plos.org/10.1371/ journal.pone.0261412.
24. Arellano C, Castro L, DÃaz Caravantes RE, Ernst KC, Hayden M, Reyes Castro P. Knowledge and Beliefs about Dengue Transmission and Their Relationship with Prevention Practices in Hermosillo, Sonora. Front Public Health [Internet]. 2015 Jun 3 [cited 2024 Jul 16];3. Available from: http://journal.frontiersin.org/Article/10.3389/ fpubh.2015.00142/abstract.
25. Islam S, Huq I. Economic Cost of Dengue: A Selective Case in Bangladesh. The International J of Applied Economics and Finance [Internet]. 2020 Dec 15 [cited 2024 Jul 18];15(1):1–10. Available from: https://www. scialert.net/abstract/?doi=ijaef.2021.1.10.
26. Sample size calculator [Internet]. [cited 2024 Jul 16]. Available from: https://www. statskingdom.com/sample_size_manova.html.
27. 9761_book_item_9761 [Internet]. Place of publication: SAGE Publications; Available from: https://us.sagepub.com/ sites/default/files/upm-assets/9761_book_ item_9761.pdf.
28. Islam M, Kabir R, Nisha M. Data Analysis with Stata A Comprehensive Guide for Data Analysis and Interpretation of Outputs First Edition Stata Version 13. 2022.
29. Rahman T, Gasbarro D, Alam K, Alam K. Rural‒urban disparities in household catastrophic health expenditure in Bangladesh: a multivariate decomposition analysis. Int J Equity Health [Internet]. 2024 Feb 27 [cited 2024 Jul 16];23(1):43. Available from: https://equityhealthj.biomedcentral.com/ articles/10.1186/s12939-024-02125-3.
30. Gainor EM, Harris E, LaBeaud AD. Uncovering the Burden of Dengue in Africa: Considerations on Magnitude, Misdiagnosis, and Ancestry. Viruses. 2022;14(2).
31. Seo J, Goodman MS, Politi M, Blanchard M, Kaphingst KA. Effect of Health Literacy on Decision-Making Preferences among Medically Underserved Patients. Med Decis Making [Internet]. 252 Vol 10 No 2 (2024) Barriers to Accessing Dengue Healthcare: A Multicenter Survey ... Nishan NH et al. 2016 May [cited 2024 Jul 16];36(4):550–6. Available from: http://journals.sagepub.com/ doi/10.1177/0272989X16632197.
32. Mainuddin A, Ara Begum H, Rawal LB, Islam A, Shariful Islam SM. Women Empowerment and Its Relation with Health Seeking Behavior in Bangladesh. J Family Reprod Health. 2015 Jun;9(2):65–73.
33. Ahmed F, Oni FA, Hossen SS. Does gender inequality matter for access to and utilization of maternal healthcare services in Bangladesh? PLoS One. 2021;16(9):e0257388.
34. Worthington RP, Gogne A. Cultural aspects of primary healthcare in india: A case based analysis. Asia Pac Fam Med [Internet]. 2011 [cited 2024 Oct 24];10(1):8. Available from: http://apfmj.biomedcentral.com/ articles/10.1186/1447-056X-10-8.
35. Bhumkittipich P, Siramaneerat I, Iamsomboon N, Bhumkittipich K. Multiple Classification Analysis (MCA) of Key Factors Affecting Women’s Empowerment through health decision making in Remote Area of Thailand. Journal of Health Research [Internet]. 2024 Mar 1 [cited 2024 Oct 24];38(3). Available from: https://digital.car. chula.ac.th/jhr/vol38/iss3/4.
36. Krist AH, Tong ST, Aycock RA, Longo DR. Engaging Patients in Decision-Making and Behavior Change to Promote Prevention. Stud Health Technol Inform. 2017;240:284– 302.
37. Mahumud RA, Sarker AR, Sultana M, Islam Z, Khan J, Morton A. Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh. J Prev Med Public Health. 2017 Mar;50(2):91–9. 38. Rony MKK, Parvin MstR, Wahiduzzaman Md, Akter K, Ullah M. Challenges and Advancements in the Health Related Quality of Life of Older People. Zhang J, editor. Advances in Public Health [Internet]. 2024 Feb 1 [cited 2024 Oct 24];2024:1–18. Available from: https://www.hindawi.com/ journals/aph/2024/8839631/
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| DOI | https://doi.org/10.18502/jbe.v10i2.17643 | |
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How to Cite
1.
NISHAN MNH, Ahmed MZEMNU, Oishy SJ, Alam A, Mashreky SR. Barriers to Accessing Dengue Healthcare: A Multicenter Survey from Dhaka, a Major Dengue Hotspot in Bangladesh. JBE. 2025;10(2):235-252.
