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Determining Perceived Self-Efficacy for Preventing Dengue Fever in Two Climatically Diverse Mexican States: A Cross-Sectional Study. Behav Sci (Basel) 2022; 12:bs12040094. [PMID: 35447666 PMCID: PMC9031455 DOI: 10.3390/bs12040094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/03/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Knowledge of dengue fever and perceived self-efficacy toward dengue prevention does not necessarily translate to the uptake of mosquito control measures. Understanding how these factors (knowledge and self-efficacy) influence mosquito control measures in Mexico is limited. Our study sought to bridge this knowledge gap by assessing individual-level variables that affect the use of mosquito control measures. A cross-sectional survey with 623 participants was administered online in Mexico from April to July 2021. Multiple linear regression and multiple logistic regression models were used to explore factors that predicted mosquito control scale and odds of taking measures to control mosquitoes in the previous year, respectively. Self-efficacy (β = 0.323, p-value = < 0.0001) and knowledge about dengue reduction scale (β = 0.316, p-value =< 0.0001) were the most important predictors of mosquito control scale. The linear regression model explained 24.9% of the mosquito control scale variance. Increasing age (OR = 1.064, p-value =< 0.0001) and self-efficacy (OR = 1.020, p-value = 0.0024) were both associated with an increase in the odds of taking measures against mosquitoes in the previous year. There is a potential to increase mosquito control awareness and practices through the increase in knowledge about mosquito reduction and self-efficacy in Mexico.
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Larson AJ, Paz-Soldán VA, Arevalo-Nieto C, Brown J, Condori-Pino C, Levy MZ, Castillo-Neyra R. Misuse, perceived risk, and safety issues of household insecticides: Qualitative findings from focus groups in Arequipa, Peru. PLoS Negl Trop Dis 2021; 15:e0009251. [PMID: 33956803 PMCID: PMC8101955 DOI: 10.1371/journal.pntd.0009251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 02/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The current body of research on insecticide use in Peru deals primarily with application of insecticides offered through Ministry of Health-led campaigns against vector-borne disease. However, there is a gap in the literature regarding the individual use, choice and perceptions of insecticides which may influence uptake of public health-based vector control initiatives and contribute to the thousands of deaths annually from acute pesticide poisoning in Peru. METHODS Residents (n = 49) of the Alto Selva Alegre and CC districts of peri-urban Arequipa participated in seven focus group discussions (FGD). Using a FGD guide, two facilitators led the discussion and conducted a role-playing activity. this activity, participants insecticides (represented by printed photos of insecticides available locally) and pretended to "sell" the insecticides to other participants, including describing their qualities as though they were advertising the insecticide. The exercise was designed to elicit perceptions of currently available insecticides. The focus groups also included questions about participants' preferences, use and experiences related to insecticides outside the context of this activity. Focus group content was transcribed, and qualitative data were analyzed with Atlas.ti and coded using an inductive process to generate major themes related to use and choice of insecticides, and perceived risks associated with insecticide use. RESULTS The perceived risks associated with insecticides included both short- and long-term health impacts, and safety for children emerged as a priority. However, in some cases insecticides were reportedly applied in high-risk ways including application of insecticides directly to children and bedding. Some participants attempted to reduce the risk of insecticide use with informal, potentially ineffective personal protective equipment and by timing application when household members were away. Valued insecticide characteristics, such as strength and effectiveness, were often associated with negative characteristics such as odor and health impacts. "Agropecuarios" (agricultural supply stores) were considered a trusted source of information about insecticides and their health risks. CONCLUSIONS It is crucial to characterize misuse and perceptions of health impacts and risks of insecticides at the local level, as well as to find common themes and patterns across populations to inform national and regional programs to prevent acute insecticide poisoning and increase community participation in insecticide-based vector control campaigns. We detected risky practices and beliefs about personal protective equipment, risk indicators, and safety levels that could inform such preventive campaigns, as well as trusted information sources such as agricultural stores for partnerships in disseminating information.
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Affiliation(s)
- Anika J. Larson
- University of Washington, School of Medicine, Seattle, Washington, United States of America
| | - Valerie A. Paz-Soldán
- Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
- Zoonotic Disease Research Lab (LIEZ), One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudia Arevalo-Nieto
- Zoonotic Disease Research Lab (LIEZ), One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Joanna Brown
- Zoonotic Disease Research Lab (LIEZ), One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carlos Condori-Pino
- Zoonotic Disease Research Lab (LIEZ), One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Michael Z. Levy
- Zoonotic Disease Research Lab (LIEZ), One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Ricardo Castillo-Neyra
- Zoonotic Disease Research Lab (LIEZ), One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Lenhart A, Morrison AC, Paz-Soldan VA, Forshey BM, Cordova-Lopez JJ, Astete H, Elder JP, Sihuincha M, Gotlieb EE, Halsey ES, Kochel TJ, Scott TW, Alexander N, McCall PJ. The impact of insecticide treated curtains on dengue virus transmission: A cluster randomized trial in Iquitos, Peru. PLoS Negl Trop Dis 2020; 14:e0008097. [PMID: 32275653 PMCID: PMC7176142 DOI: 10.1371/journal.pntd.0008097] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 04/22/2020] [Accepted: 01/28/2020] [Indexed: 11/18/2022] Open
Abstract
Dengue is one of the most important vector-borne diseases, resulting in an estimated hundreds of millions of infections annually throughout the tropics. Control of dengue is heavily dependent upon control of its primary mosquito vector, Aedes aegypti. Innovative interventions that are effective at targeting the adult stage of the mosquito are needed to increase the options for effective control. The use of insecticide-treated curtains (ITCs) has previously been shown to significantly reduce the abundance of Ae. aegypti in and around homes, but the impact of ITCs on dengue virus (DENV) transmission has not been rigorously quantified. A parallel arm cluster-randomized controlled trial was conducted in Iquitos, Peru to quantify the impact of ITCs on DENV seroconversion as measured through plaque-reduction neutralization tests. Seroconversion data showed that individuals living in the clusters that received ITCs were at greater risk to seroconverting to DENV, with an average seroconversion rate of 50.6 per 100 person-years (PY) (CI: 29.9–71.9), while those in the control arm had an average seroconversion rate of 37.4 per 100 PY (CI: 15.2–51.7). ITCs lost their insecticidal efficacy within 6 months of deployment, necessitating re-treatment with insecticide. Entomological indicators did not show statistically significant differences between ITC and non-ITC clusters. It’s unclear how the lack of protective efficacy reported here is attributable to simple failure of the intervention to protect against Ae. aegypti bites, or the presence of a faulty intervention during much of the follow-up period. The higher risk of dengue seroconversion that was detected in the ITC clusters may have arisen due to a false sense of security that inadvertently led to less routine protective behaviors on the part of households that received the ITCs. Our study provides important lessons learned for conducting cluster randomized trials for vector control interventions against Aedes-transmitted virus infections. Dengue is one of the most important mosquito-borne diseases affecting humans, resulting in an estimated hundreds of millions of infections annually throughout the tropics. To control dengue, most public health programs use a variety of methods to kill the primary mosquito vector, Aedes aegypti. Water holding containers that harbor larvae (and other immature stages) are treated or eliminated. During emergencies, large insecticide spray campaigns are deployed to kill infected adult mosquitoes. Innovative interventions that are effective at targeting adult mosquitoes in sustainable ways are needed to increase the options for control of dengue and other Aedes borne virus diseases. The use of insecticide-treated curtains (ITCs) has previously been shown to significantly reduce Ae. aegypti numbers in and around homes, but the impact of ITCs on dengue virus (DENV) transmission has not previously been quantified. Using a rigorous study design in which 10 clusters (~90 houses per cluster) were provided multiple ITCs to place in their homes was compared to 10 clusters of homes without ITCs. Assignment of which clusters received ITCs was randomized. Blood samples were obtained at 9-month intervals from residents living in all the clusters, so that people with serological evidence of a DENV infection could be identified by comparing paired samples. Seroconversion data showed that individuals living in the clusters that received ITCs were at greater risk to DENV seroconverting, with an average seroconversion rate of 50.6 per 100 person-years (PY) (CI: 29.9–71.9). Conversely, those in the control arm had an average seroconversion rate of 37.4 per 100 PY (CI: 15.2–51.7). ITCs lost their insecticidal efficacy within 6 months of deployment, necessitating re-treatment with insecticide. Ae. aegypti populations did not show statistically significant differences between ITC and non-ITC clusters. The reason for higher transmission in the ITC treated clusters could be attributable to failure of the curtains (loss of efficacy) and/or that the curtains were not sufficiently effective at protecting against mosquito bites. The higher risk of DENV seroconversion in ITC clusters may be due to a false sense of security that inadvertently led to less routine protective behaviors on the part of households that received the ITC.
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Affiliation(s)
- Audrey Lenhart
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Amy C. Morrison
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
- Department of Virology, U.S. Naval Medical Research Unit-6, Lima and Iquitos, Peru
- * E-mail:
| | - Valerie A. Paz-Soldan
- Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Brett M. Forshey
- Department of Virology, U.S. Naval Medical Research Unit-6, Lima and Iquitos, Peru
| | - Jhonny J. Cordova-Lopez
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Helvio Astete
- Department of Virology, U.S. Naval Medical Research Unit-6, Lima and Iquitos, Peru
| | - John P. Elder
- San Diego State University, San Diego, California, United States of America
| | - Moises Sihuincha
- Director, Department of Internal Medicine, Hospital de Apoyo Iquitos, Peru
| | - Esther E. Gotlieb
- Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Eric S. Halsey
- Department of Virology, U.S. Naval Medical Research Unit-6, Lima and Iquitos, Peru
| | - Tadeusz J. Kochel
- Department of Virology, U.S. Naval Medical Research Unit-6, Lima and Iquitos, Peru
| | - Thomas W. Scott
- Department of Entomology and Nematology, University of California, Davis, California, United States of America
| | - Neal Alexander
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Philip J. McCall
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Aguerre IM, Riley-Powell AR, Weldon CT, Pajuelo M, Celis Nacimento RA, Puente-Arnao A, Cabrera L, Oberhelman RA, Paz-Soldan VA. "Knocking on Doors that Don't Open": experiences of caregivers of children living with disabilities in Iquitos and Lima, Peru. Disabil Rehabil 2019; 41:2538-2547. [PMID: 29909702 PMCID: PMC6345615 DOI: 10.1080/09638288.2018.1471741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 04/11/2018] [Accepted: 04/29/2018] [Indexed: 10/28/2022]
Abstract
Background: More than one billion people worldwide live with a disability. Despite advances in recognising inequalities experienced by people with disabilities, barriers to services and stigmatisation still exist. The aims of this study were to explore: (1) perceptions and experiences of services specifically available to people with disabilities and their caregivers and (2) the perception of disability. Methods: In-depth interviews were conducted with 20 caregivers of persons with a disability and 14 key informants in two cities in Peru; Lima and Iquitos. The social-ecological model was used as a framework to analyse and present data, stratifying the key barriers and opportunities at each level. Results: At the individual level, interviewees reported a lack of support at the time of diagnosis, poor coping strategies, and communicated their desire for, and willingness to participate in support groups if they were established. On the community level, education and awareness were reportedly lacking and acts of discrimination and stigmatisation were common. Participants described opportunities for community-level campaigns to increase exposure and awareness of disability rights and inclusion. A dissatisfaction with government programmes was reported, as services were not available to everyone, in part due to geographical and socio-economic barriers. Conclusions: The main findings were the lack of emotional, informational, and tangible support available to caregivers of people with disabilities, often exacerbated by lower socio-economic status; a lack of transparency of care pathways available to people with disabilities; and a lack of visibility of people with disability in both Lima and Iquitos. Implications for Rehabilitation Support groups could offer additional support to caregivers of people with disabilities in Lima, mitigating existing gaps in services for people with disabilities, and their families. Education campaigns implemented on a community level could start to curb discrimination and stigmatisation of people with disabilities in Lima and Iquitos. A national census with inclusive language and methodology specifically designed to capture the percentage of the population currently living with a disability would give a real indication of what services are needed in Peru. The provision of clear, publically available routes of attention would assist caregivers and families to access services for people with disabilities.
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Affiliation(s)
- Ines M. Aguerre
- Tulane University, School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112 USA
| | - Amy R. Riley-Powell
- Tulane University, School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112 USA
| | - Caroline T. Weldon
- Tulane University, School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112 USA
| | - Monica Pajuelo
- Tulane University, School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112 USA
- Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Distrito de Lima, Lima, Perú
| | - Rosa A. Celis Nacimento
- Asociación Benéfica PRISMA, Carlos Gonzales N°251, Urbanización Maranga San Miguel, PO Box 170070, Lima 32, Perú
| | - Anité Puente-Arnao
- Asociación Educativa Kallpa, Av. Primavera 1860, Santiago de Surco, Lima, Perú
| | - Lilia Cabrera
- Asociación Benéfica PRISMA, Carlos Gonzales N°251, Urbanización Maranga San Miguel, PO Box 170070, Lima 32, Perú
| | - Richard A. Oberhelman
- Tulane University, School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112 USA
| | - Valerie A. Paz-Soldan
- Tulane University, School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112 USA
- Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Distrito de Lima, Lima, Perú
- Asociación Benéfica PRISMA, Carlos Gonzales N°251, Urbanización Maranga San Miguel, PO Box 170070, Lima 32, Perú
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Weldon CT, Riley-Powell AR, Aguerre IM, Celis Nacimento RA, Morrison AC, Oberhelman RA, Paz-Soldan VA. "Zika is everywhere": A qualitative exploration of knowledge, attitudes and practices towards Zika virus among women of reproductive age in Iquitos, Peru. PLoS Negl Trop Dis 2018; 12:e0006708. [PMID: 30161130 PMCID: PMC6135521 DOI: 10.1371/journal.pntd.0006708] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 09/12/2018] [Accepted: 07/21/2018] [Indexed: 11/19/2022] Open
Abstract
Zika virus was reported in the rainforest city of Iquitos, Peru in 2016. The potential associations between Zika and fetal neurological disorders were reported extensively in the media regarding neighboring Brazil, and led to great concern about the impact Zika could have on people's health in Iquitos when it arrived. The aim of this study was to explore the knowledge, attitudes, and preventative practices related to Zika virus and its transmission among women of childbearing age in Iquitos, Peru. Six focus group discussions with 46 women of ages 20-35 from an Iquitos district with confirmed Zika cases were conducted to explore: 1) knowledge of Zika transmission, its symptoms, and treatment, 2) attitudes regarding Zika, including perceptions of risk for and severity of Zika, and 3) preventative practices, including awareness of health promotion activities. Participants were knowledgeable about Zika symptoms and knew it was transmitted by mosquitoes, and about half had heard about the association between Zika and microcephaly, but most lacked knowledge about the associated neurological disorders in adults, its sexual transmission, and ways to prevent infection. They expressed concern for pregnant women exposed to the virus and the impact on the fetus. Participants felt at risk of contracting the Zika virus, yet had not changed preventive practices, possibly in part because their perception of the severity of this disease was low. This study reveals knowledge gaps that could be addressed via health promotion messages that might improve prevention practices to help community members protect themselves from Zika virus during this outbreak.
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Affiliation(s)
- Caroline T. Weldon
- Tropical Medicine Department, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Amy R. Riley-Powell
- Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Ines M. Aguerre
- Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | | | - Amy C. Morrison
- Department of Entomology and Nematology, University of California, Davis, Davis, California, United States of America
| | - Richard A. Oberhelman
- Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Valerie A. Paz-Soldan
- Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
- Asociación Benéfica PRISMA, Lima, Peru
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The Use of Insecticide-Treated Curtains for Control of Aedes aegypti and Dengue Virus Transmission in "Fraccionamiento" Style Houses in México. J Trop Med 2018; 2018:4054501. [PMID: 30018645 PMCID: PMC6029453 DOI: 10.1155/2018/4054501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 03/30/2018] [Accepted: 04/05/2018] [Indexed: 11/17/2022] Open
Abstract
Dengue, chikungunya, yellow fever, and Zika viruses transmitted by Aedes aegypti mosquitoes are major public health threats in the tropical and subtropical world. In México, construction of large tracts of “fraccionamientos” high density housing to accommodate population growth and urbanization has provided fertile ground for Ae. aegypti-transmitted viruses. We investigated the utility of pyrethroid-treated window curtains to reduce both the abundance of Ae. aegypti and to prevent dengue virus (DENV) transmission in fraccionamiento housing. Windows and doors of fraccionamiento homes in urban/suburban areas, where Ae. aegypti pyrethroid resistance associated with the Ile1016 knock down resistance (kdr) mutation in the voltage gated sodium channel gene was high, and in rural areas, where kdr resistance was low, were fitted with either insecticide-treated curtains (ITCs) or non-treated curtains (NTCs). The homes were monitored for mosquito abundance and DENV infection. ITCs reduced the indoor abundance of Ae. aegypti and the number of DENV-infected mosquitoes in homes in rural but not in urban/suburban study sites. The presence of non-treated screens also was associated with reduced numbers of mosquitoes in homes. “Super-infested” homes, yielding more than 50 mosquitoes, including DENV-infected mosquitoes, provide a significant public health risk to occupants, visitors, and people in neighboring homes.
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Pérez D, Van der Stuyft P, Toledo ME, Ceballos E, Fabré F, Lefèvre P. Insecticide treated curtains and residual insecticide treatment to control Aedes aegypti: An acceptability study in Santiago de Cuba. PLoS Negl Trop Dis 2018; 12:e0006115. [PMID: 29293501 PMCID: PMC5766245 DOI: 10.1371/journal.pntd.0006115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 01/12/2018] [Accepted: 11/14/2017] [Indexed: 11/21/2022] Open
Abstract
Background Within the context of a field trial conducted by the Cuban vector control program (AaCP), we assessed acceptability of insecticide-treated curtains (ITCs) and residual insecticide treatment (RIT) with deltamethrin by the community. We also assessed the potential influence of interviewees’ risk perceptions for getting dengue and disease severity. Methodology/principal findings We embedded a qualitative study using in-depth interviews in a cluster randomized trial (CRT) testing the effectiveness of ITCs and RIT in Santiago de Cuba. In-depth interviews (N = 38) were conducted four and twelve months after deployment of the tools with people who accepted the tools, who stopped using them and who did not accept the tools. Data analysis was deductive. Main reasons for accepting ITCs at the start of the trial were perceived efficacy and not being harmful to health. Constraints linked to manufacturer instructions were the main reason for not using ITCs. People stopped using the ITCs due to perceived allergy, toxicity and low efficacy. Few heads of households refused RIT despite the noting reasons for rejection, such as allergy, health hazard and toxicity. Positive opinions of the vector control program influenced acceptability of both tools. However, frequent insecticide fogging as part of routine AaCP vector control actions diminished perceived efficacy of both tools and, therefore, acceptability. Fifty percent of interviewees did feel at risk for getting dengue and considered dengue a severe disease. However, this did not appear to influence acceptability of ITCs or RIT. Conclusion/significance Acceptability of ITCs and RIT was linked to acceptability of AaCP routine vector control activities. However, uptake and use were not always an indication of acceptability. Factors leading to acceptability may be best identified using qualitative methods, but more research is needed on the concept of acceptability and its measurement. We aimed to understand what makes insecticide-treated curtains (ITCs) and residual insecticide treatment (RIT) with deltamethrin acceptable or not to users of these tools. In-depth interviews were conducted as part of a field trial conducted by the Cuban vector control program (AaCP) to test the effectiveness of these tools in Santiago de Cuba. Perceived efficacy was the main reason for interviewees who accepted the tools. Constraints linked to manufacturer instructions were the main reason for not using the ITCs when offered at the start of the trial. People stopped using the ITCs due to perceived allergy, toxicity and low efficacy. Few heads of households refused RIT despite identifying various reasons for rejection, such as allergy, health hazard and toxicity. Positive opinions of the Cuban vector control program influenced acceptability of both tools. On the contrary, perceptions of dengue risk did not appear to influence acceptability of ITCs or RIT. Our findings add on the importance of the growing body of qualitative research assessing acceptability of health interventions.
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Affiliation(s)
- Dennis Pérez
- Department of Epidemiology, Institute of Tropical Medicine Pedro Kourí, Havana, Cuba
- * E-mail:
| | - Patrick Van der Stuyft
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Public Health, Ghent University, Ghent, Belgium
| | - María Eugenia Toledo
- Department of Epidemiology, Institute of Tropical Medicine Pedro Kourí, Havana, Cuba
| | - Enrique Ceballos
- Department of Vector Control, Polyclinic Armando García, Santiago de Cuba, Cuba
| | - Francisco Fabré
- Department of Vector Control, Provincial Surveillance and Vector Control Unit, Santiago de Cuba, Cuba
| | - Pierre Lefèvre
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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