Factors influencing healthcare seeking in patients with dengue: systematic review

Tze Chang Ng, Chin Hai Teo*, Jia Yong Toh, Adam G. Dunn, Chirk Jenn Ng, Tan Fong Ang, Adina Abdullah, Ayeshah Syed, Hooi Min Lim, Kathleen Yin, Chee Sun Liew

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)


Objective: Delays in seeking healthcare for dengue are associated with poor health outcomes. Despite this, the factors influencing such delays remain unclear, rendering interventions to improve healthcare seeking for dengue ineffective. This systematic review aimed to synthesise the factors influencing healthcare seeking of patients with dengue and form a comprehensive framework. Methods: This review included both qualitative and quantitative studies. Studies were obtained by searching five databases, contacting field experts and performing backward reference searches. The best-fit meta-synthesis approach was used during data synthesis, where extracted data were fitted into the social-ecological model. Sub-analyses were conducted to identify the commonly reported factors and their level of statistical significance. Results: Twenty studies were selected for meta-synthesis. Eighteen factors influencing healthcare seeking in dengue were identified and categorised under four domains: individual (11 factors), interpersonal (one factor), organisational (four factors) and community (two factors). The most reported factors were knowledge of dengue, access to healthcare, quality of health service and resource availability. Overall, more barriers to dengue health seeking than facilitators were found. History of dengue infection and having knowledge of dengue were found to be ambiguous as they both facilitated and hindered dengue healthcare seeking. Contrary to common belief, women were less likely to seek help for dengue than men. Conclusions: The factors affecting dengue healthcare-seeking behaviour are diverse, can be ambiguous and are found across multiple social-ecological levels. Understanding these complexities is essential for the development of effective interventions to improve dengue healthcare-seeking behaviour.

Original languageEnglish
Pages (from-to)13-27
Number of pages15
JournalTropical Medicine and International Health
Issue number1
Early online date16 Oct 2021
Publication statusPublished - Jan 2022


  • decision making
  • dengue
  • health seeking
  • health services accessibility
  • help-seeking behaviour
  • meta-synthesis
  • patient acceptance of healthcare
  • systematic review


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