Community-driven policy recommendations for dengue prevention and control in Thailand: A mixed-methods study

Abstract

Background: The World Health Organization roadmap targets the eradication of dengue, a neglected tropical disease. Community participation is crucial for successful control efforts, which must transcend technical solutions to engage and motivate the public. This study examined the needs, perceptions, and emotional drivers underpinning dengue prevention efforts and recommended tailored policies to control dengue in varied settings. Methods: This mixed-methods study, using a triangulation design, was conducted in four geographical regions of Thailand between November 2023 and April 2024. Quantitative surveys were administered to 664 community members and 430 public health personnel, complemented by 10 focus group discussions (FGDs) with community members, 16 FGDs, and 23 in-depth interviews (IDIs) with public health personnel. Logistic regression was used to examine factors associated with dengue control practices, while qualitative data were analyzed thematically. Findings from both components were integrated during interpretation to enhance the robustness of conclusions. Results: Integrated quantitative and qualitative findings showed that most participants practiced active dengue prevention. Social support strongly influenced preventive behaviors (OR 19.81; 95 % CI 8.53–46.03), whereas demographic factors and perceived susceptibility or severity were not significant. Higher practice levels were observed among participants in the northeast and health personnel aged ≥ 50 years. Qualitative data reinforced these findings, emphasizing the vital role of village health volunteers and challenges such as limited participation, low risk perception, poor sanitation, and cultural barriers shaping vaccine hesitancy. Conclusion: Effective dengue control requires context-specific, evidence-based strategies that strengthen community participation, empower village health volunteers, and enhance vector control. Early warning systems and intersectoral collaboration are vital in high-risk areas, while transparent, culturally tailored communication can improve vaccine acceptance. These findings provide evidence to guide policy toward sustainable, community-centered dengue prevention and control.