CONTRIBUTORY FACTORS LEADING TO THE INCREASE OF DENGUE CASES IN

BONTOC ILI

In Partial Fulfilment of the Requirements in Nursing Research 1

GROUP MEMBERS:

BUGATAN, JEEANN

CAWED, SHERLYN

DACYON, CLAUDINE

DAPUYEN, ZYRA

DASING, AMY

DINNANGHAY, JEZREEL

FANIG, PRINCESS

GAW-AY, INELUZ

GUIT-ANG, ROILAND

HABBILING, NESLIN

INODAYAN, JOAN

KATTER, FLOIDA ROSE

KIWWA, TONY JESHER

BSN 3C

GROUP 2

RESEARCH INSTRUCTOR:

MA’AM ANNIE LOURIE Y. PAREDES

 INTRODUCTION

BACKGROUND OF THE STUDY

Dengue is a viral infection transmitted to humans through the bite of infected mosquitoes. Aedes
aegypti mosquitoes and, to a lesser extent, Ae are the main carriers of the disease. Dengue
virus is the name of the virus that causes dengue (DENV). Dengue is a tropical and subtropical
disease that primarily affects urban and semi-urban settings. About half of the world's
population is now at risk due to the sharp increase in dengue incidence worldwide. Although
between 100 and 400 million infections are thought to occur annually, more than 80% are often
mild and asymptomatic.

The incidence of dengue has increased dramatically in recent decades, with estimates of 40%-
50% of the world’s population at risk for the disease in tropical, subtropical, and, most recently,
more temperate areas. Many individuals with dengue may be asymptomatic. Many patients with
dengue experience a prodrome of chills; rash, including erythematous mottling of the skin; and
facial flushing, which may last 2-3 days. Children younger than 15 years who have dengue
usually have a nonspecific febrile syndrome, which may be accompanied by a maculopapular
rash. Dengue should be suspected in individuals who present with high fever (104°F/40°C),
retro-orbital headache, muscle and joint pain, nausea, lymphadenopathy, vomiting, and rash
and who have traveled within 2 weeks of symptom onset to an area where appropriate vectors
are present and dengue transmission may be occurring.

Moreover, according to the article entitled "Dengue and typhoid fever cases recorded in
Bontoc", dengue cases were recorded in Bontoc to include two cases each in Barangays
Caluttit, Samoki, and Bontoc Ili and three in Barangay Poblacion. Nine dengue cases were
recorded in the four central barangays of Bontoc while eight barangays recorded a total of 11
typhoid fever cases in May this year. Further, the data of Municipal Health Office (2022) shows
that there has been an increase of cases in Bontoc. Year 2021 has over 89 reported cases which
dramatically increased in 2022 with over 247 number of cases. In addition, Bontoc Ili has 78 cases and 1
death, making it as the barangay with the highest dengue fever cases.

With this issue at hand, the purpose of this study is to determine the contributory factors leading
to the increase of dengue cases in Bontoc Ili. The barangay has the highest number of cases
over the municipality for consecutive years.
 RESEARCH QUESTIONS

This research entitled "Contributory Factors Leading To The Increase of Dengue Cases in
Bontoc Ili" attempts to answer the following:

1. What are the present contributory factors in barangay Bontoc Ili that influence the increase of
dengue cases?

2. What are the practices of Lower Calutit, Bontoc, Mt. Province residents that influences
dengue cases?

3. Are there preventive measures that Bontoc Ili is conducting to decrease the number of
dengue cases?

4. What is the main contributory factor leading to the increase of dengue cases in Bontoc Ili?

5. What is the contributory factor that leads to the increase of dengue cases in Bontoc Ili
according to :

a) Age

b) Educational Attainment

6) Is there a significant difference in the contributory factors that leads to the increase of dengue
cases in Bontoc Ili according to :

a) Age

b) Educational Attainment

HYPOTHESIS

There is no significant difference in the contributory factors leading to the increase

ofdengue cases in Bontoc Ili when compared according to age and educational attainment.
 REVIEW OF RELATED LITERATURE

Dengue is a mosquito-borne viral disease that has rapidly spread to all regions of WHO
in recent years. Dengue virus is transmitted by female mosquitoes mainly of the species Aedes
aegypti and, to a lesser extent, Ae. albopictus. These mosquitoes are also vectors of
chikungunya, yellow fever and Zika viruses. Dengue is widespread throughout the tropics, with
local variations in risk influenced by climate parameters as well as social and environmental
factors (WHO, 2022). There are contributing factors that lead to the increase of dengue in the
community.

According to the World Health Organization (2022), the factors leading to the increased
risk of developing severe dengue in the community are the following: previous infection with
Dengue Virus (DENV); social factors such as population density and human mobility;
environmental factors such as access to reliable water source and water storage practice; the
population's knowledge, attitude and practice towards dengue; the implementation of routine
sustainable vector control activities in the community; and climate change in tropical and
subtropical areas wherein vectors might adapt to new environment and climate.

In recent years, dengue fever has increased in the Philippines to worrying levels. The
Philippines' Department of Health (DOH) reported an estimated 84,085 suspected dengue
cases from January 1 to August 6, 2016, a 15.8% increase over the 72,627 cases reported
during the same period in 2015; 372 of these cases were fatal. As of 2012, the Philippines has
the fourth-highest position among the ten Association of South East Asian Nations (ASEAN)
countries for dengue cases. This alarming rate is partly due to several factors such as
environmental degradation, climatic condition, lack of clean water supply, inappropriate waste
disposal and management, rapid urbanization, increasing population, and poor mosquito
surveillance and control system all contributed to the increasing number of dengue cases in the
country (Iguchi, J.,Seposo, X., & Honda, 2018).

In relation, according to the research entitled "Impact of environmental factors on the

spread of dengue fever in Sri Lanka", the result stated that precipitation, humidity, and air
pressure significantly influenced the spread of dengue fever in Sri Lanka. The climate season
significantly influenced dengue fever transmission, and a higher infection rate was found in the
northeast monsoon season. Moreover, according to a senior scientist working in the National
Institute of Virology, Pune, the extended spell of rains is a primary cause for the rampant spread
of dengue in India for it has led to increase of mosquito breeding. The number of people
affected by dengue is rising across the country with over 80,000 cases and 60 fatalities reported
from 12 states, according to data from the National Centre for Vector-borne Diseases Control
(Kumar, A., 2022). However, another study conducted in India found that population growth,
rapid urbanization, increase in international travel from endemic areas and global warming are
playing a major role in disease spread (Srinivas, B., 2015). In addition, a research entitled "Risk
factors for dengue outbreaks in Odisha, India: A case-control study", household factors such as
occupation and ecological condition of households play important roles in dengue outbreaks in
Odisha.

Whereas, according to a research conducted in Pakistan, the current expansion of

dengue seems multifactorial and may include climate change, virus evolution, and societal
factors such as rapid urbanization, population growth and development, socioeconomic factors,
as well as global travel and trade. Population growth, rapid urbanization, increase in
international travel from endemic areas and global warming are playing a major role in disease
spread.
 CONCEPTUAL FRAMEWORK

This portion presents the conceptual framework of the study. It illustrates the variables
and their relationships.

DEPENDENT VARIABLE

INDEPENDENT VARIABLE • Previous infection with dengue

virus
Contributory Factors Leading to
the increase of dengue cases in • Social factors ( population
Bontoc Ili density and human mobility)

• environmental factors ( access

to reliable water source and
water storage practice)
 It shows that the general problem of the research is to determine the factors contributing
to the increase of dengue cases at Bontoc Ili. The framework contains the different contributory
factors as it's dependent variable.

To mention, age and educational attainment of the peope from Bontoc Ili towards
dengue are the intervening variables playing a significant role in the analysis of determining the
main contributory factor leading to the increase of dengue cases in Bontoc Ili.

INTERVENING VARIABLE

•Age

•Educational Attainment
 SIGNIFICANCE OF THE STUDY

The result of this study aims to benefit the following:

Researchers. This study will enable the researcher to provide concrete evidence of the
presence of factors that are not easily identified and were seemingly neglected by the
community without realizing that the factors are the main roots of the issue. In addition, the
researcher will contribute to the literature in relation to dengue.

People of the Barangay. The study makes an important contribution to the community of
Barangay Bontoc Ili by creating awareness of the severity of dengue. As a result, the barangay
will explore more effective preventive measures to reduce the increase of disease cases.

Nursing Profession. Result of this study will help the nurses, especially the nurse in the
community as well as the municipal and provincial health office to develop and render useful
teachings and other strategies to control the increase of dengue cases.

Future Researcher. This study will serve as a guide to future researchers that may want
to start a new research about Contributory Factors Leading to the Increase of Dengue Cases in
Barangay Bontoc Ili, Bontoc.

Prevention and control of dengue fever occurrence interview guide

Level of dengue occurrence

1. Which places are you concerned about getting dengue?

2. Have you been diagnosed with dengue?

3. Have you experienced fever accompanied by any of the following: general rash,
muscle cramps nausea, vomiting, pain behind the eyes, reddish skin?

Prevention

1. What do you do to personally protect yourself from mosquito bites?

2. Are there any observed programs or activities that are being implemented by
organizations in the community to prevent the spread of dengue virus?

3. What is the environment related preventive measures that you re conducting in

your surroundings?

a. how often do you clean your surrounding?

b. how do you dispose your household garbage?

c. where do you dispose containers that can collect clean water?

d. How do you clean debris that may block water flow in drain or roof gutter
 e. What do you do in water containers used for storing water in and out of the
house before going to a long vacation. (removing, covering)

f. How do you manage dark places in and out of the house as prevention of
dengue?

g. What do you use to trap mosquitoes? (mosquito coil, mosquito net, liquid
vaporizer, mosquito bulb or trap)

h. Are there ways you do or plant to sway away mosquito? What are they?

i. what do you do to keep water containers be free of mosquito breeding site?

Management and Treatment

1. Which is your best option for treatment of dengue fever, Intake of over the
counter drugs (or self-medication), seeking for medical consult or utilizing traditional treatment
using herbal medicine? why?

a. What do you do to prevent mosquito bites

b. what color do you prefer to use to avoid mosquito bites (bright colors)

c. what do you use or apply in your body to prevent mosquito bites?

2. Follow up;

a.) Intake of OTC drugs; name of drug

What symptoms does it relieves?

b.) Seeking for medical consult; where? (e.g. barangay clinic, RHU, hospital

c.) utilizing traditional treatment: what are the medicinal herbs used used? Or
traditional practices made?

3. do you have home treatment to treat the symptoms of dengue? If there are, what
are they?

Contributory factors

1. What do you generally do to keep your household and surrounding be free of

mosquito?
 2. Are there presence of breeding sites?

3. In your barangay what might harbor mosquito breeding site and bites?

SURVEY QUESTIONNAIRE

Survey questionnaire on the prevention and control of dengue fever among

residents of Central Bontoc

NAME (optional); ____________________________________________

Barangay: ___________________________________________________

1. Direction: Please put a check mark honestly based on what you actually do
given the statements using the following scales;

5- always 4- often 3- usually 2- seldom 1- never

Statements 5 4 3 2 1

Level of dengue occurrence

1. Have you been or any of your family diagnosed with dengue

2. Are you concerned about getting dengue in your barangay

3.

4.

Prevention

1. Use insecticide sprays to reduce mosquitos

2. Use professional pest control to reduce

3. mosquitos.

4. Use screen windows to reduce mosquitos

5. Use bed nets reduce mosquitos

6. Eliminates standing water around the house to reduce mosquitos

7. Use mosquito coils reduce mosquitos

 8. Covers water containers at home

9. Cleans water filled containers and ditches around the house

10. Destroy the mosquito breeding site (stock water)

11. Avoid putting tires outdoors

Treatment and management

1. Take paracetamol (OTC drugs)

2. Drink plenty of fluids

3. Stay in bed

4. Use of bright colored clothes

5. Use of insect repellant lotion

6. Agrees to vaccine to prevent dengue infection

7. Change stored water

8. Examine for mosquito larvae in containers for storing water

9. Cover or clean canals/ dirty irrigations

10. Participate in general cleaning

11. Properly segregate and dispoel household/kitchen wastes?

Contributory factors

1. Are there presence of mosquito breeding sites?

2.

1. Any further questions or concerns?

___________________________________________

______________________________________________________________________
________
 2. What can you say or suggest for the prevention and control of dengue fever
occurrence?__________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____

M Uematsu and C. Mazier, Knowledge, Attitudes, and Practices Regarding Dengue

among the General Population in Honduras,American Journal of Public Health Research Vol. 4,
No. 5, 2016, pp 181-187. doi: 10.12691/ajphr-4-5-4 | Research Article

Li Ping Wong, Sharina Mahavera Mohamad Shakir, Narges Atefi, Sazaly AbuBakar,
Factors Affecting Dengue Prevention Practices: Nationwide Survey of the Malaysian Public,
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0122890

WHO. Dengue and severe dengue 2014. Available:

http://www.who.int/mediacentre/factsheets/fs117/en/.

The KAP Survey Model (Knowledge, Attitudes, and Practices), https://www.spring-

nutrition.org/publications/tool-summaries/kap-survey-model-knowledge-attitudes-and-practices
 LITERATURE CITED

Iguchi, J.,Seposo, X., & Honda. (2018, March 15). Meteorological factors affecting dengue

incidence in Davao, Philippines. Accessed on January 06, 2023. Accessed at doi:

10.1186/s12889-018-5532-4

Faruk, M.O., Jannat, S.N. & Rahman, Md.S. (2022, January 14). Impact of

environmental factors on the spread of dengue fever in Sri Lanka. International Journal
of Environmental Science and Technology volume 19, pages10637–10648 (2022)
Accessed on November 18,2022. Accessed from
https://link.springer.com/article/10.1007/s13762-021-03905-y

Jehangir Khan, Inamullah Khan, Abdul Ghaffar & Bushra Khalid (2018, June 15).

Epidemiological trends and risk factors associated with dengue disease in Pakistan
(1980–2014): a systematic literature search and analysis. BMC Public Health volume 18,
Article number: 745 (2018). Accessed on November 18, 2022. Accessed from
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5676-2

Kumar, A. (2022). Dengue cases rise pan-India, Kerala sees most deaths. Accessed on

November 18, 2022. Accessed from

https://www.moneycontrol.com/news/trends/dengue-cases-rise-pan-india-kerala-sees-
most-deaths-9390341.html

Srinivas, V. (2015,April) Dengue Fever: A review article. Journal of Evolution of Medical

and Dental Sciences 4(29):5048-5058 Accessed on November 18, 2022. Accessed on

DOI:10.14260/jemds/2015/736

Swain, S., Bhatt, M., Biswal, D., Pati, S., & Magalhaes, R.J. (2020, April 07). Risk

factors for dengue outbreaks in Odisha, India: A case-control study. Journal of Infection
and Public Health. Volume 13, Issue 4, April 2020, Pages 625-631. Accessed on
November 18, 2022. Accessed from
https://www.sciencedirect.com/science/article/pii/S1876034119302953

Tuladhar, R., Singh, A., Varma, A., & Choudhary, D.K. (2019, March 13). Climatic

factors influencing dengue incidence in an epidemic area of Nepal. BMC Research

Notes volume 12, Article number: 131 (2019). Accessed on November 18, 2022.
Accessed from https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-019-
4185-4

World Health Organization (2022, January 10) Dengue and severe dengue. Accessed

on November 18,
 2022. Accessed from https://www.who.int/news-room/fact-sheets/detail/dengue-and-
severe-dengue

Xiaobo Liu, Keke Liu, Yujuan Yue, Haixia Wu, Shu Yang, Yuhong Guo, Dongsheng Ren,

Ning Zhao, Jun Yang, & Qiyong Liu (2021, January 18). Determination of Factors
Affecting Dengue Occurrence in Representative Areas of China: A Principal Component
Regression Analysis. Accessed on November 18, 2022. Accessed from doi:
10.3389/fpubh.2020.603872
 ANNEX D
Letter of Request for Research Adviser

Mountain Province State Polytechnic College

Bontoc, Mountain Province

Date: January 20, 2023

GEORGINA P. MASKAY
Nursing Department
Mountain Province State Polytechnic College

Sir/Madam:

We are conducting a research proposal titled "Contributory Factors Leading to

the Increase of Dengue Cases in Bontoc Ili ", as a requirement of the course
(title of research proposal/research)
__Nursing Research_1_____ of the 1st/2nd semester, SY 2022 to 2023.
(course title & description) (school year)

In view of this, we would like to invite you as our Research Adviser by virtue of
your educational experience, expertise, and research record. As our proposed adviser,
your primary function is to guide and assist us in all activities related to our research
undertaking.
We look forward to your favorable response. Thank you.

Very truly yours,

JOAN L. INODAYAN
BSN 3
(Signature over printed name, course & year of research leader)

Noted:
ALFRED O. FOMOCAO, JR.
(Signature over printed name of Department Chairperson)
______________________________________________________________________
Acknowledgement and Confirmation

This is to confirm that I am willing to serve as research adviser of the group.

GEORGINA P. MASKAY
(Signature over printed name of research adviser)
 ANNEX D
Letter of Request for Research Adviser

Mountain Province State Polytechnic College

Bontoc, Mountain Province

Date: January 20, 2023

LEA L. PANCHO
Nursing Department
Mountain Province State Polytechnic College

Sir/Madam:

We are conducting a research proposal titled "Contributory Factors Leading to

the Increase of Dengue Cases in Bontoc Ili ", as a requirement of the course
(title of research proposal/research)
__Nursing Research_1_____ of the 1st/2nd semester, SY 2022 to 2023.
(course title & description) (school year)

In view of this, we would like to invite you as our Research Adviser by virtue of
your educational experience, expertise, and research record. As our proposed adviser,
your primary function is to guide and assist us in all activities related to our research
undertaking.
We look forward to your favorable response. Thank you.

Very truly yours,

JOAN L. INODAYAN
BSN 3
(Signature over printed name, course & year of research leader)

Noted:
ALFRED O. FOMOCAO, JR.
(Signature over printed name of Department Chairperson)
______________________________________________________________________
Acknowledgement and Confirmation

This is to confirm that I am willing to serve as research adviser of the group.

LEA L. PANCHO
(Signature over printed name of research adviser)
 ANNEX D
Letter of Request for Research Adviser

Mountain Province State Polytechnic College

Bontoc, Mountain Province

Date: January 20, 2023

ALFRED O. FOMOCAO, JR.

Nursing Department
Mountain Province State Polytechnic College

Sir/Madam:

We are conducting a research proposal titled "Contributory Factors Leading to

the Increase of Dengue Cases in Bontoc Ili ", as a requirement of the course
(title of research proposal/research)
__Nursing Research_1_____ of the 1st/2nd semester, SY 2022 to 2023.
(course title & description) (school year)

In view of this, we would like to invite you as our Research Adviser by virtue of
your educational experience, expertise, and research record. As our proposed adviser,
your primary function is to guide and assist us in all activities related to our research
undertaking.
We look forward to your favorable response. Thank you.

Very truly yours,

JOAN L. INODAYAN
BSN 3
(Signature over printed name, course & year of research leader)

Noted:
ALFRED O. FOMOCAO, JR.
(Signature over printed name of Department Chairperson)
______________________________________________________________________
Acknowledgement and Confirmation

This is to confirm that I am willing to serve as research adviser of the group.

ALFRED O. FOMOCAO, JR.

(Signature over printed name of research adviser)
 ANNEX D
Letter of Request for Research Adviser

Mountain Province State Polytechnic College

Bontoc, Mountain Province

Date: January 20, 2023

ALMA JOY W. PATINGAN

Nursing Department
Mountain Province State Polytechnic College

Sir/Madam:

We are conducting a research proposal titled "Contributory Factors Leading to

the Increase of Dengue Cases in Bontoc Ili ", as a requirement of the course
(title of research proposal/research)
__Nursing Research_1_____ of the 1st/2nd semester, SY 2022 to 2023.
(course title & description) (school year)

In view of this, we would like to invite you as our Research Adviser by virtue of
your educational experience, expertise, and research record. As our proposed adviser,
your primary function is to guide and assist us in all activities related to our research
undertaking.
We look forward to your favorable response. Thank you.

Very truly yours,

JOAN L. INODAYAN
BSN 3
(Signature over printed name, course & year of research leader)

Noted:
ALFRED O. FOMOCAO, JR.
(Signature over printed name of Department Chairperson)
______________________________________________________________________
Acknowledgement and Confirmation

This is to confirm that I am willing to serve as research adviser of the group.

ALMA JOY W. PATINGAN

(Signature over printed name of research adviser)