DENGUE PREVENTION: CONFIRMATORY FACTOR ANALYSIS OF RELATIONSHIPS BETWEEN ECONOMIC STATUS, KNOWLEDGE, ATTITUDES AND PRACTICE, VACCINE ACCEPTANCE AND WILLINGNESS TO PARTICIPATE IN A STUDY.

The aim of this study was to study the relationships between economic status, knowledge, attitude and practice regarding dengue fever (DF), attitude towards vaccination against dengue virus infection, willingness to participate in a study on dengue, and acceptance of a dengue vaccine. Information on variables of interest was collected in questionnaire-assisted interviews during a communitybased cross-sectional survey conducted in Aceh, Indonesia. A proposed relationship model was tested using Confirmatory Factor Analysis (CFA), and an Exploratory Factor Analysis (EFA) was used to reconstruct an alternative relationship model among variables. Our proposed relationship model differed from the result of the EFA. The CFA indicated that knowledge and attitudes towards DF had the strongest relationship. We also found several direct relationships between sets of variables: a) economic status and knowledge on DF, b) economic status and practices regarding DF, c) knowledge and practices regarding DF, d) attitudes towards DF and dengue vaccine acceptance, as well as e) attitudes towards vaccination and dengue vaccine acceptance. There was no relationship between economic status and dengue vaccine acceptance. In conclusion, our model suggested that the most suitable factor to be targeted for improving dengue prevention was knowledge about DF. In addition, improving attitudes towards vaccination seemed to be the most appropriate effort to increase public acceptance of a dengue vaccine.