Evaluating knowledge and attitudes towards dengue fever and its vaccination in China: A questionnaire-based study in healthcare practitioners

Dengue, a mosquito-borne tropical disease caused by the dengue virus, has seen a significant increase in global incidence in recent decades. China has experienced a rapid rise in dengue cases since 2013, posing a serious threat to population health and increased economic burden. This study aimed to evaluate the knowledge and attitudes towards dengue fever and dengue vaccination among healthcare practitioners in China. A cross-sectional study was conducted using an online questionnaire survey targeting medical professionals in Zhejiang, Yunnan, and Hainan provinces, which are known endemic areas for dengue virus infection in China. The questionnaire assessed participants understanding of dengue virus transmission, high-risk groups, symptoms, knowledge of and attitude towards dengue vaccines. Results showed that 98.6% of participants reported having prior knowledge of the dengue virus. The knowledge of at-risk populations was strongly associated with actual dengue knowledge and vaccine attitude, which potentially drives vaccine acceptance. Most respondents (71.0%) held neutral attitudes towards dengue vaccine, followed by 20.8% that held positive attitudes and 8.2% that held negative attitudes. Individuals with neutral attitude were the most critical in determining the vaccine acceptance rate. Among those that accepted vaccine, 56.1% held neutral attitude, and among those that refused vaccine, 84.3% held neutral attitude. Whilst most respondents (87.6%) reported that they would advocate for the vaccination of susceptible populations against dengue, only 7.5% of respondents were aware of the existence of approved dengue vaccines. This study provides valuable insights into the current state of knowledge and attitudes towards dengue fever and vaccination among healthcare practitioners in China. Association of various knowledge domains with vaccine attitudes and vaccine acceptance shed light on the more impactful direction for emphasis through educational campaigns and vaccine promotion. Author summaryThe evaluation on the knowledge and attitudes towards dengue fever and dengue vaccination among healthcare practitioners in China is crucial in determining the future environment on vaccination policy development. As China has not introduced any dengue vaccines, endemic regions rely greatly on non-pharmaceutical interventions and post-infection treatments. This article reveals the misconceptions and concerns of dengue and dengue vaccines in the medical community in China, which are potential and effect targets of targeted interventions and communication directions that public health authorities can work on to ultimately reduce health burden. This study also identifies false knowledge that are commonly shared, providing an effective reference for endemic regions to learn better of the dengue virus as well as the benefits and health requirements of the dengue vaccine before they make the decision for vaccination. We believe that the introduction and research for dengue virus vaccine would bring beneficial impacts for the Chinese population. The findings of this study provide a scientific basis for decision-making and offer valuable insights for designing effective dengue related education campaigns that can maximize their impact on vaccine attitudes and acceptance.