Abstract
Mosquito-borne diseases are a major public health concern. Because of absence of effective therapy and vaccination to treat and prevent such vector-borne diseases, these initial cases have triggered strong concerns within medical communities, turning a bad dream into reality. To date, reducing the mosquito vector population remains the main strategy to control the transmission of mosquito borne diseases. In this connection, community-based perception recognized as an essential tool for long-term vector control management. In this study, a community perception survey was carried out in six selected study areas of Ganjam district of Odisha. A total of 3257 inhabitants from randomly chosen 600 no. of houses from 06 selected study areas were interviewed using a pre-tested structured questionnaire about various mosquito vector-borne diseases. As an outcome, we found that only 36% of people have basic knowledge and idea about vector-borne diseases, out of which only 14% know Anopheles as a causative agent whereas Aedes and Culex were very least concern. Regarding the source of knowledge, electronic media was the principal source of information, while the involvements of health personnel were least mentioned. Results of the current study indicates the necessity to plan health education program to bring important perceptions regarding vector-borne diseases at school and college level because the infrequent source of knowledge is the main cause of an increase in the disease incidence.
Mosquitoes are one of the deadliest creatures in the world. Their ability to carry and spread disease to humans causes millions of deaths every year. Most of the mosquito-borne diseases are transmitted by those belonging to the genera: Anopheles, Aedes and Culex. Anopheles mosquito transmits Malaria that causes an estimated 219 million cases globally and results in more than 4,00,000 deaths every year. Similarly, Dengue is another most prevalent viral infection transmitted by Aedes mosquitoes affecting more than 3.9 billion people over 129 countries with an estimated 96 million cases and an estimated 40,000 deaths every year. 1 Other diseases transmitted by Aedes mosquito include Chikungunya, Zika, Yellow fever etc. Similarly, Culex mosquitoes are the principal vectors for West Nile fever, Japanese encephalitis etc.
As revealed by the frequent outbreaks in the past decade and position at the red zone in the global map confers that mosquito vector borne diseases are major public health concern in India. 2 Endemic of Malaria, Chikungunya and Japanese encephalitis create a threat condition of mosquito vector borne diseases in India. Earlier the mosquito borne diseases were mainly restricted to urban and sub-urban areas of country but now it spread in rural areas, because of the availability of favorable breeding sites of disease vectors. Emerging insecticidal resistance and lack of expertise in vector control is important reason behind insurgent of these vector borne diseases.
The incidence of diseases depends on the interaction of the several ecological and social aspects of the community. So it is important to provide awareness about knowledge of mosquito vectors in the community. To make community-based programs successful, it is important to know the community’s perceptions about mosquitoes and mosquito borne disease transmission, mosquitoes breeding habits and their practices for mosquito vector control. 3
Govt. of India started a program by the name of National Vector Borne Disease Control Program (NVBDCP) intending to control mosquito borne diseases and it greatly relies on community participation. Unfortunately, the program deviated from its track and was unable to control the outbreaks, because community participation is not always simple.4,5 Dormancy of prevention and control measures in communities is due to non-allineate of community knowledge with established strategies.6–8
The ignorance of people contributes to the establishment of simple breeding habitats which eventually responsible for the intensification of mosquitoes population. The outcome is responsible for the steady increase in the cases of vector borne diseases which hinders the disease control strategies. General public is ignorant of mosquito borne diseases and symptoms and so promptness in treatment is not realized. People are still confused over symptoms of various mosquito borne fevers and its control measures. Major part of the population is poor in disease evaluation, ignorance towards health and control of mosquito population. Community therefore, must understand the importance of environmental cleanliness and utilization of water bodies in an effective way.
In almost all regions of India, although there are many mass communication and educational tactics, but the community participation is far away from the expectation. 9 Successful long-term results as an outcome of control strategies greatly depend upon the behavior of local community. Understanding the way the local population has developed a thought about the vector-borne diseases and continuous communications are the only choices for the successive outcome.10–14 Keeping on this background, a cross-sectional study was carried out in some areas of Ganjam district of Odisha in 2015–16 focusing on knowledge regarding mosquito borne diseases and their causative agent.
Materials and Methods
Study Area and Study Population
A cross-sectional study was carried out in 06 selected areas of Ganjam district such as Aska, Buguda, Bhanjanagar, Bhetanai, Ballipadar and Baunsalundi. Out of the total no. of houses, 100 houses were randomly selected for each study area (Table 1). Houses were visited in the study area and study purpose was explained. Adult above 18 years who present at home was interviewed using a pre-tested structured questionnaire regarding knowledge and practices about mosquito vector-borne diseases. The pre-designed and pre-tested proforma was used to collect the data. The questionnaire consisted of questions regarding information on various aspects of mosquito vectors, mosquito bite, breeding places of mosquito, measures of prevention of mosquito bite, diseases transmitted by mosquito bite and service utilization for diseases. The people have interacted in regional language and the information was collected as earlier made by Pandit et al. 15 Informed verbal consent was obtained from household heads before inclusion as participants. Face to face interviews with inhabitants of the house of study areas provided us information about their awareness regarding mosquito biting habitat, biting time, breeding place etc. The collected information in the form of data was coded in Microsoft Excel and analyzed. In addition, whether any member of their family suffered by any mosquito-borne diseases or not and if suffered then what kind of steps they have taken were also discussed.
Total Inhabitants and Population of Different Study Areas of Ganjam District of Odisha.
Result
A fixed 100 no of houses were randomly selected from each study area and inhabitants of those areas were interviewed regarding their knowledge on mosquito vector-borne diseases. A total of 3257 inhabitants were interviewed in 600 houses from 06 selected study areas (Table 1). The details regarding knowledge of people of different study areas of Ganjam district about mosquito vector and mosquito vector-borne diseases were recorded.
Perception of Mosquitoes as Vectors
Before the implementation of National Vector Borne Disease Control Program by Govt. of India, people were unable to differentiate the various mosquito vectors. During this study, a somewhat satisfactory response with a score of about 30% was recorded for Anopheles mosquito as a vector. While, the responses towards Aedes and Culex as other mosquito vectors, is least concerned. In some study areas, similar to earlier days the communities continued to discuss mosquitoes in a generalized way and unable to differentiate them. Area wise detail responses were recorded and presented in Figure 1.

Knowledge of Respondents About Types of Mosquito (A: Buguda, B: Ballipadar, C: Aska, D: Bhetanai, E: Bhanjanagar, F: Baunsalundi).
Perception of Mosquito-Borne Diseases
From an earlier time, mosquito vector borne diseases were not considered as a primary menace. However, several outbreaks in the recent past increase the level of concern. Before the time of continuous outbreaks of different vector-borne diseases, Malaria is the only known mosquito-borne disease to the local communities in the study areas. During this study, we noticed that the community health concerns were mainly focused on non-communicable and lifestyle associated diseases such as hypertension, cancer and diabetes. After frequent outbreaks and due to continuous awareness over television and newspapers, the community gains a tiny knowledge about other mosquito-borne diseases such as Dengue, Filarial and Chikungunya. The detailed responses recorded from different study areas were presented in Figure 2.

Knowledge of Inhabitants About Mosquito Borne Diseases (A: Buguda, B: Ballipadar, C: Aska, D: Bhetanai, E: Bhanjanagar, F: Baunsalundi).
Perception of Source of Information About Mosquito-Borne Diseases
Several outbreaks in recent past change the level of concern and discussion towards mosquito-borne diseases. In this regard, the source of information for broadcasting knowledge about various mosquito-borne diseases and their causative agent plays a pivotal role. During this perception survey, we recorded the responses for Television as a principal source for information followed by advertisements by non-govt. organizations and local newspapers. However, it was disappointing to note that doctors or health staff were not mentioned as the source of knowledge. The involvement of health personals was least recorded in all the study areas. The detailed responses towards the source of information were presented in Figure 3.

Source of Information About Mosquito and Mosquito Borne Diseases (A: Buguda, B: Ballipadar, C: Aska, D: Bhetanai, E: Bhanjanagar, F: Baunsalundi).
Perception of Preventive Measures and Control Strategies
In similar to an earlier time, Mosquito coil, mosquito mat, repellent, mosquito net and traditional Neem leaf burning, straw and cow dung smoke, egg case smoke were the various methods of personal protective measures amongst the study participants. Commercial products as mosquito repellents were always the best choice and mostly used by communities as preventive measures. However, communities were least specific about the cleaning houses and the prevention of water stagnation in the surroundings. The detailed responses about preventive measures were recorded and presented in Figure 4. The use of bed nets supplied by the Govt. was measured on average scale as an effective method for control strategies.

Different types of Preventions used in different study sites (A: Buguda, B: Ballipadar, C: Aska, D: Bhetanai, E: Bhanjanagar, F: Baunsalundi).
Discussion
The success of mosquito vector control methods depends upon the knowledge and perception of the community people living in that particular area. Therefore, it is vital to understand the level of knowledge and perception of the community about mosquito vector and mosquito vector borne diseases, the practices followed by the people to prevent mosquito bites and to know the requirements of type of media for effective broadcasting of information.
Community perception study of inhabitants was carried out in the present investigation to understand the knowledge regarding mosquito biting time, season, breeding sites, source of information, causes, mode of transmission, symptoms, treatment, and prevention (personal protection) of mosquito-borne diseases as well as knowledge of mosquito vector in the selected rural areas such as Ballipadar, Bhetanai and Baunsalundi and urban areas such as Buguda, Aska and Bhanjanagar of Ganjam district, Odisha state. Similar kinds of community perception studies were also carried out in different parts of Odisha state and it was observed that few people use bed nets 16 which was similar to the findings of the current study. From this study, it was also observed that most of the people of selected rural areas did not know about different types of mosquito and mosquito-borne diseases. But very few people knew about the seriousness of these diseases. In urban areas, the percentage of knowledge about the mosquito and mosquito vector borne diseases were more than the rural areas. When a particular question was asked on the name of a disease related to mosquito, most preferred answer was malaria followed by filaria and a little about dengue but no knowledge about chikungunya and yellow fever both in rural as well as urban areas except in Aska, where some people know about chikungunya. A question related to the most common symptom of different mosquito borne diseases, fever was the most preferred answer by the respondents. Most of them also didn’t know about the appropriate vector of a particular mosquito borne disease in all six surveyed study areas. It was also observed that television was the major source of information in rural areas, but in urban areas along with television other sources were newspapers, relatives, friends etc. Most of the inhabitants of the selected study area are using coils followed by liquid for their protection against mosquito borne diseases.
It was disappointing to note that doctors or health personals were rarely mentioned as the source of knowledge regarding mosquito-borne diseases. When practice about the prevention of mosquito bite was enquired, it was noticed that one or more personal practices were adopted by the inhabitants. Mosquito repellent coils were the main preventive measure followed by the liquid, mosquito killing bats in almost all selected study areas. In similar to the earlier study of Gunasekaran et al. 17 the percentage of using mosquito bed nets was found more in urban areas than the rural areas. Regarding the treatment for mosquito-borne diseases, people depend upon the primary health center followed by private practitioners, non-Government hospital etc. in rural areas but in urban areas along with the other available facilities a good number of people like self-medication. The inhabitants of urban areas were less aware of mosquito and mosquito-borne diseases, and their knowledge on cause, symptom and transmission of these diseases was poor. Most of them did not know the role of mosquitoes in the transmission of the disease. Similar answers were also shared from inhabitants of rural areas of Ganjam district at the time of discussion. Further, it is important to aware people that there are other mosquito-borne diseases and mosquito vectors apart from malaria and its vector which can cause morbidity and mortality and can be prevented.
Conclusion
The Government should intensify the campaign against the mosquito borne diseases and should take proper action for the elimination of breeding sites of mosquitoes. The importance of combining field surveillance activities with the community understanding may provide an inclusive tool for declining the frequency of mosquito borne diseases. Since most people prefer to go Government and non-Government hospitals for treatment of these diseases, so health personnel should be well trained to give more appropriate counseling. Therefore, it necessary to plan health education programme to bring important perceptions not only to the people of Ganjam district but also other parts of the state regarding vector-borne diseases by Government personnel, Non-Government Organization (NGO) etc. at school and college level because the infrequent source of knowledge is the main cause of an increase in the disease incidence.
Footnotes
Acknowledgments
The authors are thankful to Prof. Deepak Kumar Behera who initiated, guided and encouraged throughout the period of study when he was Vice-Chancellor of , Berhampur University, Berhampur, Odisha .
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
