Marklet

research questionnaire

Factors Associated With Dengue Fever Transmission

Introduction

Dear Respondent, I am conducting a study on factors associated with dengue fever transmission in Tononoka Ward, Mvita Sub-County, Mombasa County. The purpose of this questionnaire is to collect information on environmental factors, residents’ knowledge regarding dengue fever prevention and transmission, and health-service factors associated with dengue fever transmission. Your participation is voluntary. The information you provide will be treated confidentially and used strictly for academic purposes. Kindly answer the questions honestly. Do not write your name on this questionnaire. Thank you for your cooperation.

Research Questionnaire: Factors Associated with Dengue Fever Transmission in Tononoka Ward

Questionnaire for Household Residents

1. What is your age?
2. What is your gender?
3. What is your highest level of education?
4. How long have you lived in Tononoka Ward?

Employed, Self-employed, Student, Unemployed, or Other

6. Stagnant water is common around my household.

SA = Strongly Agree; A = Agree; N = Neutral; D = Disagree; SD = Strongly Disagree.

7. Poor drainage contributes to mosquito breeding in my area.

SA = Strongly Agree; A = Agree; N = Neutral; D = Disagree; SD = Strongly Disagree.

8. Uncovered water storage containers encourage mosquito breeding.

SA = Strongly Agree; A = Agree; N = Neutral; D = Disagree; SD = Strongly Disagree.

9. Poor waste disposal increases mosquito breeding sites.

SA = Strongly Agree; A = Agree; N = Neutral; D = Disagree; SD = Strongly Disagree.

10. The environment in my neighbourhood increases the risk of dengue transmission.

SA = Strongly Agree; A = Agree; N = Neutral; D = Disagree; SD = Strongly Disagree.

11. Does your household store water?

Covered containers, Uncovered containers, Water tanks, Drums, or Other

13. Have you noticed mosquitoes breeding around your household?
14. How often do you experience mosquito bites?
15. Have you ever heard of dengue fever?
16. What causes dengue fever?
17. Which mosquito transmits dengue fever?
18. Which of the following are symptoms of dengue fever? (Tick all that apply)
19. Can dengue fever be prevented?
20. Which measures can help prevent dengue fever? (Tick all that apply)

Loading…