Knowledge attitude and preventive behaviors towards hand foot and mouth disease among caregivers of children under five years old in Bangkok Thailand

Abstract

HFMD is an emerging disease which has potential to become Thai public health problem in the future. This disease normally affects young children and there is no effective vaccine for disease prevention; therefore, the disease prevention and control mainly rely on HFMD preventive behaviors of their caregivers. The aims of this cross sectional study were to assess the level of knowledge, attitude and preventive behaviors practice towards HFMD; and to determine factors associated to them among home caregivers of children under 5 years old. The 2-stage cluster sampling technique was used to select 9 nurseries from 9 districts in Bangkok and self –administered questionnaire was used to collect data from 456 home caregivers in Bangkok, Thailand. The results indicated that 50.4% of them had low knowledge and only of 3.7% had high overall knowledge about HFMD. Generally, they had moderate (68.2%) to good (31.8%) overall attitude towards HFMD; however, they seemed to perceive that HFMD was more severe than it actually was, since only 1.8% of them had good attitude in severity aspect. In term of behavior, 60% of them performed preventive behavior at good level. Nevertheless, some preventive behaviors were still insufficiently performed. The statistically significant correlation between overall knowledge and attitude (p=0.000, r=0.193); knowledge and behavior (p=0.000, r=0.163); and attitude and behavior (p=0.000, r=0.371) were found in this study. Many socio-demographic characteristics were associated to HFMD knowledge, attitude and preventive behavior, especially family income and education which were associated to all the KAP variables. Results from multiple regression analysis (F=30.497, p<0.001, R² =0.213) revealed that the caregivers’ attitude was the strongest predictor of the home caregivers’ HFMD preventive behavior (β=0.308, t=7.007, p<0.001) followed by family income per month (β=0.205, t=4.698, p<0.001), gender (β=0.127, t=3.021, p=0.003), and knowledge (β=0.086, t=1.996, p<0.047). In conclusion, findings from this study highlighted the need to provide more HFMD educational program emphasizing on attitude change to the home caregivers especially among those caregivers with low income and low education. Providing HFMD information via television should be considered since television was the main source of information of the home caregivers (97.6%).