A Study in Guyana Shows an Interplay between Individual Risk Perception and Preventive Behaviour for Vector-Borne Diseases

The more people fear a disease, the more actions they take to prevent it. Knowledge about the disease also increases preventive behaviour, but only if the perceived risk is high enough. However, an increase in prevention leads in turn to a decrease in risk perception, according to a study performed in Guyana and led by ISGlobal, an institution supported by the “la Caixa” Foundation. To avoid a decrease in prevention, governments need to raise awareness of the risks and facilitate access to preventive measures.

Individual behaviour plays an important role in increasing or decreasing the transmission of infectious diseases, including those that are transmitted by vectors. In turn, a person’s behaviour is influenced by his or her perceived risk of the disease. Individuals who do not like risk will increase their preventive behaviour, particularly when vaccines are inexistent and/or treatments are unavailable. Conversely, as the transmission of the infection decreases, risk perception may decrease and, with it, the demand for prevention. However, the association between risk perception and preventive behaviour is not always clear. “We need to better understand the factors that shape human behaviour regarding disease prevention, if we are to succeed in eliminating these diseases,” says ISGlobal researcher Elisa Sicuri.

In this study, her team explored whether preventive behaviour responds to risk perception, taking into account the individual’s knowledge of the disease, and his or her socioeconomic and demographic characteristics. “The innovative aspect of this study is that it focuses on four vector-borne diseases (malaria, dengue, Zika and cutaneous leishmaniasis) and that it was performed in Guyana, a country where almost no research has been conducted on the topic”, explains Celine Aerts, first author of the study.

Almost 500 participants from four regions of the country answered questions on disease knowledge, risk perception and use of preventive measures for the four diseases. The findings show that there is an association between risk perception and behaviour, and that it works both ways: an increase in risk perception results in an increase in preventive behaviour for all diseases; but an increase in preventive behaviours may in turn lead to a decrease in risk perception. They show that measures subsidized by the government (specifically bed nets) were highly used, regardless of the perceived risk. “Our findings also suggest that if the overall risk perception of a disease is low, as was observed for Zika and leishmaniasis, greater knowledge is not sufficient to trigger a behavioural change”, says Sicuri.

The region in which individuals live also plays a key role in the use of vector control measures: people living in the hinterland tend to have greater knowledge about the disease and an accurate risk perception, but they use fewer preventive measures than those living in the coast. This points to the importance of promoting access to preventive measures in these regions.

The authors conclude that, in trying to achieve the elimination of vector-borne diseases, the government should regularly promote awareness of the risks and facilitate (or donate) access to preventive measures.

Reference:

Aerts C, Revilla M, Duval L, et al. Understanding the role of disease knowledge and risk perception in shaping preventive behavior for selected vector-borne diseases in Guyana. PLoS Negl Trop Dis. 2020. 14(4):e0008149. doi: 10.1371/journal.pntd.0008149