Determinants of insect repellent use to prevent dengue infection among travelers visiting Lipe island, Thailand: A cross-sectional survey

Abstract

Background Dengue infection is a mosquito-borne disease affects many regions of the world, including Lipe islands that are popular tourist destinations with high Aedes larval density by house index. The Protection Motivation Theory (PMT) is applied to determine relationships among knowledge, perception and preventive practice of dengue infection by using insect repellent among island travelers. Methods A cross-sectional study was conducted using a self-administered questionnaire among travelers aged 18 years or older between October 2024 and January 2025. The insect repellent use was obtained from self-reports during staying on the Lipe Island. Data was analyzed by descriptive statistics, the Chi-square test, and logistic regression, with a significance level set at p-value <0.05. Results Among 419 respondents, 206 and 213 were Thais and international travelers. With a median age in each group as 35 and 32 years old respectively. The proportion of insect repellent use was 69.2%. The determinants influencing the use of insect repellent for Dengue prevention were international travelers (aOR: 3.151, 95%CI = 1.710-5.806), staying in Lipe Island for 6-7 days (aOR:4.941, 95%CI = 1.501-16.265), high perceived response efficacy (aOR: 2.004, 95%CI = 1.203-3.338), high perceived self-efficacy (aOR: 2.259, 95%CI = 1.377-3.706) and low perceived response cost (aOR = 1.712, 95%CI = 1.033-2.838), All factors were able to predict the preventive practices at 72%. Conclusion About two-thirds of travelers use insect repellent in the island. Improvement in perceive self-efficacy, response efficacy and response cost among this group can increase the efficacy of dengue prevention in the island setting.