Environmental, preventive behavioral, and socioeconomic determinants of dengue hemorrhagic fever at Haji General Hospital Medan: A cross-sectional analysis

Abstract

Background: Dengue hemorrhagic fever (DHF) remains a serious public health problem in Indonesia. The incidence of DHF is influenced by interacting factors, including physical environmental conditions, community preventive behavior, and socioeconomic conditions. Purpose: This study aimed to analyze the factors associated with the incidence of DHF at Haji General Hospital Medan and to determine the most dominant determinant. Methods: This study used an observational analytic quantitative design with a cross-sectional approach. It was conducted at Haji General Hospital Medan with 81 respondents. Data were collected through interviews using structured questionnaires and observation sheets. Analysis was performed using univariate methods, bivariate analysis with the Pearson chi-square test, and multivariate analysis with binary logistic regression. Result: The majority of respondents lived in poor environmental conditions (55.6%), exhibited inadequate preventive behavior (55.6%), and had low socioeconomic status (55.6%). A total of 26 respondents (32.1%) were diagnosed with DHF. Bivariate analysis revealed a significant association between environmental factors (p = 0.000) and preventive behavior factors (p = 0.009) with DHF incidence. Conversely, socioeconomic status did not show a statistically significant association (p = 0.089). Multivariate analysis indicated that environmental factors were the most dominant determinant associated with DHF incidence (p = 0.004; OR = 6.377; 95% CI: 1.808 to 22.494). Respondents living in poor physical environmental conditions were 6.377 times more likely to contract DHF compared with those in good environmental conditions. Conclusion: Physical environmental factors related to residential areas are the primary determinants influencing the incidence of DHF among patients treated at Haji General Hospital Medan. It is recommended that the community intensify 3M Plus mosquito breeding site eradication activities and maintain the cleanliness of the physical environment. The hospital and the Health Office should intensify education regarding environmental management for DHF prevention.