Behavioral and Environmental Determinants of Dengue Hemorrhagic Fever Occurrence in North Semarang District

Abstract

Background: DHF remains a public health problem in coastal areas. This study aimed to identify behavioural and environmental factors associated with DHF incidence in North Semarang District.Methods: An analytic observational study with a case-control design was conducted from April to June 2026 in North Semarang District. The final dataset used for multivariable analysis comprised 100 respondents, consisting of 58 respondents in the DHF group and 42 respondents in the non-DHF group. Data were collected using structured interviews and environmental observations. Variables analysed included knowledge of DHF, PSN 3M Plus practice, and environmental risk. Bivariate analysis used the Chi-square test, while multivariable analysis used binary logistic regression.Result: Knowledge level and environmental risk were significantly associated with DHF occurrence. Respondents with high knowledge had lower odds of DHF than those with low knowledge (AOR = 0.186; 95% CI = 0.069–0.502; p < 0.001). Respondents living in risky environmental conditions had higher odds of DHF (AOR = 6.005; 95% CI = 2.182–16.521; p < 0.001). PSN 3M Plus practice was not statistically significant after adjustment (AOR = 0.495; 95% CI = 0.182–1.343; p = 0.167). The final model was statistically significant (Omnibus test p < 0.001), with Nagelkerke R² = 0.429 and overall classification accuracy of 81.0%.Conclusion: Risky environmental conditions, low knowledge, and poor PSN 3M Plus practices increase the risk of DHF. Integrated vector control and community involvement are essential.