Household representatives’ understanding of dengue solutions and larval indices surveillance systems in southern Thailand: A mixed methods study

Background Dengue fever remains a major public health concern in tropical regions, particularly in Southeast Asia. Effective prevention depends on the community’s understanding of both dengue control measures and vector surveillance systems. This study assessed and explored household representatives’ understanding of dengue solutions (care and preventive measures) and the Aedes larval index surveillance system in southern Thailand. Methods A community-based convergent mixed-methods study was conducted among 824 household representatives selected through stratified random sampling. Quantitative data were collected using a structured questionnaire and analyzed using logistic regression to identify factors associated with understanding. Qualitative data were collected through in-depth interviews with 13 purposively selected participants and analyzed using thematic analysis. Findings were integrated using a joint display approach. Results Only 28.9% of participants demonstrated a high understanding of the dengue solution, and 1.2% had a high understanding of the larval indices surveillance system. Training attendance (AOR 2.01, 95% CI: 1.45–2.78), fewer water containers (AOR 2.06, 95% CI: 1.20–3.54), and higher larvae-positive containers (AOR 0.64, 95% CI: 0.43–0.97) were significantly associated with lower understanding. Qualitative findings revealed the following key themes: recognition of dengue fever, awareness of preventive practices, risky season, and the importance of training. Training was identified as a key factor in improving understanding and practices. Conclusion Household heads’ understanding of dengue prevention is limited, particularly regarding larval surveillance systems. Household representatives were familiar with dengue symptoms; they lacked technical knowledge of surveillance systems. Strengthening community-based training and improving the communication of technical concepts are essential to enhance dengue prevention and control efforts.