Nding has also been observed in contraception [61?3] and malaria [64] studies, in which such an effect is explained by a higher capacity of communication and negotiation. It seems that these two elements serve as a mechanism for consolidation, providing a better understanding of dengue. These findings and its congruence with other health outcomes pave the road to further exploration of the mechanisms in which joint decision making improves knowledge and empowerment within the household across the health spectrum [63]. Although many studies have conducted KAP surveys, few studies have addressed the question of the associated factors to preventive practices for dengue, and most of them havePLOS Neglected Tropical Diseases | DOI:10.1371/journal.pntd.0005016 September 28,11 /KAP Surveys and Dengue Control in Colombiadescribed these practices or their association with immature forms of the vector [54,65,66]. Despite this, our findings of a lack of significant association between practices score and sociodemographic characteristics are also found in other studies (in Jamaica, Cuba, and Vietnam) in which the authors suggest that cultural factors could lead to certain practices [20,53,67,68]. This hypothesis has been addressed by other studies and is a growing interdisciplinary field [69]. The main recommendation of the World Health Organization (WHO) and the Pan American Health Organization (PAHO) is to control the immature forms of Aedes aegypti for the recent Zika and Chikungunya outbreaks in the Americas [70,71]. This study suggests the need for further assessment of the determinants of the practices of vector control that move beyond sociodemographic factors. Moreover, it provides an additional tool for tackling the routine questionnaires performed during vector control campaigns. Since this is a cross-sectional buy BEZ235 analysis, one limitation is the impossibility of establishing the temporality of the relationships described. Moreover, even when considering fixed effects that allow controlling for the correlation between households of the same cluster, it is not possible to control for unmeasured confounding variables that vary over time, such as seasonal preventive interventions in some neighborhoods or unequal access to media that could confound the effect of sociodemographic characteristics on knowledge scores. Even though selection bias is a possibility, we think there are mainly three reasons for not thinking this will affect our results. The first reason is mainly because we think that since we were I-BRD9 web assessing household behavior there was no better informant than the housewife itself, most of the times when asking other person in the house they would refer or even ask the housewife about some of the practices. The second reason is that 30 of the women reported working rather than housewifery. This indicates that recruitment time also allowed us to have information about women whose main activity was different from housewifery. Finally, when exploring other studies in which KAP about dengue was done 5 out 8 reported more or equal to 50 of its participants as housewives [18,72?5] and only 3 reported a proportion of less than 20 [51,52,54]. This makes us think that this might be a characteristic of the type of survey that we are doing rather than a bias. In spite of the previous literature search and collection of most of the KAP questionnaires applied in the region for the development of the survey, comparability with other studies was a c.Nding has also been observed in contraception [61?3] and malaria [64] studies, in which such an effect is explained by a higher capacity of communication and negotiation. It seems that these two elements serve as a mechanism for consolidation, providing a better understanding of dengue. These findings and its congruence with other health outcomes pave the road to further exploration of the mechanisms in which joint decision making improves knowledge and empowerment within the household across the health spectrum [63]. Although many studies have conducted KAP surveys, few studies have addressed the question of the associated factors to preventive practices for dengue, and most of them havePLOS Neglected Tropical Diseases | DOI:10.1371/journal.pntd.0005016 September 28,11 /KAP Surveys and Dengue Control in Colombiadescribed these practices or their association with immature forms of the vector [54,65,66]. Despite this, our findings of a lack of significant association between practices score and sociodemographic characteristics are also found in other studies (in Jamaica, Cuba, and Vietnam) in which the authors suggest that cultural factors could lead to certain practices [20,53,67,68]. This hypothesis has been addressed by other studies and is a growing interdisciplinary field [69]. The main recommendation of the World Health Organization (WHO) and the Pan American Health Organization (PAHO) is to control the immature forms of Aedes aegypti for the recent Zika and Chikungunya outbreaks in the Americas [70,71]. This study suggests the need for further assessment of the determinants of the practices of vector control that move beyond sociodemographic factors. Moreover, it provides an additional tool for tackling the routine questionnaires performed during vector control campaigns. Since this is a cross-sectional analysis, one limitation is the impossibility of establishing the temporality of the relationships described. Moreover, even when considering fixed effects that allow controlling for the correlation between households of the same cluster, it is not possible to control for unmeasured confounding variables that vary over time, such as seasonal preventive interventions in some neighborhoods or unequal access to media that could confound the effect of sociodemographic characteristics on knowledge scores. Even though selection bias is a possibility, we think there are mainly three reasons for not thinking this will affect our results. The first reason is mainly because we think that since we were assessing household behavior there was no better informant than the housewife itself, most of the times when asking other person in the house they would refer or even ask the housewife about some of the practices. The second reason is that 30 of the women reported working rather than housewifery. This indicates that recruitment time also allowed us to have information about women whose main activity was different from housewifery. Finally, when exploring other studies in which KAP about dengue was done 5 out 8 reported more or equal to 50 of its participants as housewives [18,72?5] and only 3 reported a proportion of less than 20 [51,52,54]. This makes us think that this might be a characteristic of the type of survey that we are doing rather than a bias. In spite of the previous literature search and collection of most of the KAP questionnaires applied in the region for the development of the survey, comparability with other studies was a c.
