How Dengue Fever is prevalent in the Population of

Please write your Age in years

Specify your gender

Female

Male

Specify the amount of members that live in your home

How is your living place?

Urban

Suburban

Rural

Do you live in the tropics?

Yes

No

What is your Ethnic Group?

What is your Socioeconomic Status?

Upper Class

Middle Class

Lower Class

Is your home place abundant in mosquitoes?

Yes

No

Have you ever taken any preventive measure for dengue fever (example: empty accumulated water in containers or Spray aerosols)

Yes

No

Have you ever suffered dengue fever?

Yes

No