Effect of education on improving knowledge and behavior for arboviral diseases: A systematic review and meta-analysis

Arboviral diseases are responsible for a high burden of disease in humans, and a significant part of disease risk reduction efforts relies on vector control methods. The elimination of potential breeding sites for the mosquito vectors and a higher level of literacy by the populations at risk could present a sustainable and environmentally friendly solution. This review aims to assess the efficacy of educational interventions for arboviral diseases on knowledge and self-reported behavior. A systematic literature search was performed using Cochrane, EMBASE, Global Health, and PubMed. References of articles retrieved were searched manually for further studies. Critical appraisal of the selected articles was performed using the Effective Public Health Practice Project tool, and studies with a control group were further assessed through the Cochrane's risk of bias tool. A summary narrative of the results and a meta-analysis was conducted. Fourteen studies fulfilling the inclusion criteria were analyzed. Overall, there was an increase in knowledge and in self-reported adoption of protective measures. No effect was found using solely printed material. A meta-analysis was performed separately for the two outcomes measured, which produced a mean standardized difference of 1.86 (95% CI: 1.33-2.39) in knowledge scores compared with the control groups. Regarding the self-reported protective behavior, the results show a summary value of odds ratio of 5.23 (95% CI: 3.09-7.36). Most of the educational interventions had a positive impact on knowledge and self-reported adoption of protective measures. More research producing stronger evidence and evaluating long-term impact is needed. © 2019 by The American Society of Tropical Medicine and Hygiene.