Re than one symptom of dengue [17,54]. In our study, we found that education levels have a positive relationship with the improvement of knowledge up to a certain point, and it does not show an effect on the higher score level. The described relationship might be caused by the decrease in variance of the households with the highest knowledge score, which does not allow us to detect differences between education levels. purchase PP58 However, this finding can also be another manifestation of the previously documented “base education hypothesis,” in which the effect of education is not linear–beyond 12 years of formal education attained (corresponding to a high school level), it does not seem to affect other outcomes in health [43]. In this case, higher levels of outcome cannot be achieved solely by increasing education, and it is suggestive that the underlying mechanisms for having detailed knowledge of dengue, such as the color of the mosquito’s legs, are different from those for middle and low levels of knowledge. Examples of such mechanisms, which are in accord with other results of this study, are the levels of empowerment of the family and their access to information, as hypothesized by Cutler and Oreopolus in their study about mortality [55,56]. Studies in other settings have found an association between socioeconomic status (SES) and knowledge; however, there are several ways to Mikamycin B supplier measure SES and knowledge. While Castro et al. used a household asset score [20] in Cuba, and Itrat used monthly income [14] in Pakistan, in this study, we used a socioeconomic stratification system utilized by the government that entails characteristics of the neighborhood and income among others [40]. The lack of a significant association in this study could be due to accounting for the confounding effect of clustering in the relationship between SES and the degree of knowledge regarding dengue. SES, as measured in the study, is clustered in neighborhoods, and other studies in the area have shown that knowledge of dengue is also clustered by neighborhoods [57]. In our study, having more than one individual within a household reporting “housekeeping” as his or her main activity during the 10 days prior to the survey indicated a negative effect on the knowledge score. This suggests that there are higher levels of informal occupations that could not be captured in the questionnaire [58]. Informality is often associated with households facing poorer economic conditions, which creates difficulty in collecting accurate data. The observed relationship with the knowledge score is identifying a different component of SES that is not captured by income or education. Further exploration of the conditions of the population that reported more than one housekeeper should be explored. The findings of this study highlight the role of joint decision making between men and women in the family’s health care as a factor that contributes to the knowledge of dengue and its transmission. Past studies have suggested the need to approach the role of gender in the distribution of household chores and its relationship with dengue [57,59]. For this study, gender roles were approached from a micro sociological perspective, in which the dynamics on a small scale (families and couples) can be observed through decision-making processes [60]. Our results evidenced that shared decision-making processes between men and women play a significant role in the acquisition of knowledge about dengue; this fi.Re than one symptom of dengue [17,54]. In our study, we found that education levels have a positive relationship with the improvement of knowledge up to a certain point, and it does not show an effect on the higher score level. The described relationship might be caused by the decrease in variance of the households with the highest knowledge score, which does not allow us to detect differences between education levels. However, this finding can also be another manifestation of the previously documented “base education hypothesis,” in which the effect of education is not linear–beyond 12 years of formal education attained (corresponding to a high school level), it does not seem to affect other outcomes in health [43]. In this case, higher levels of outcome cannot be achieved solely by increasing education, and it is suggestive that the underlying mechanisms for having detailed knowledge of dengue, such as the color of the mosquito’s legs, are different from those for middle and low levels of knowledge. Examples of such mechanisms, which are in accord with other results of this study, are the levels of empowerment of the family and their access to information, as hypothesized by Cutler and Oreopolus in their study about mortality [55,56]. Studies in other settings have found an association between socioeconomic status (SES) and knowledge; however, there are several ways to measure SES and knowledge. While Castro et al. used a household asset score [20] in Cuba, and Itrat used monthly income [14] in Pakistan, in this study, we used a socioeconomic stratification system utilized by the government that entails characteristics of the neighborhood and income among others [40]. The lack of a significant association in this study could be due to accounting for the confounding effect of clustering in the relationship between SES and the degree of knowledge regarding dengue. SES, as measured in the study, is clustered in neighborhoods, and other studies in the area have shown that knowledge of dengue is also clustered by neighborhoods [57]. In our study, having more than one individual within a household reporting “housekeeping” as his or her main activity during the 10 days prior to the survey indicated a negative effect on the knowledge score. This suggests that there are higher levels of informal occupations that could not be captured in the questionnaire [58]. Informality is often associated with households facing poorer economic conditions, which creates difficulty in collecting accurate data. The observed relationship with the knowledge score is identifying a different component of SES that is not captured by income or education. Further exploration of the conditions of the population that reported more than one housekeeper should be explored. The findings of this study highlight the role of joint decision making between men and women in the family’s health care as a factor that contributes to the knowledge of dengue and its transmission. Past studies have suggested the need to approach the role of gender in the distribution of household chores and its relationship with dengue [57,59]. For this study, gender roles were approached from a micro sociological perspective, in which the dynamics on a small scale (families and couples) can be observed through decision-making processes [60]. Our results evidenced that shared decision-making processes between men and women play a significant role in the acquisition of knowledge about dengue; this fi.