Mosquito Avoidance Practices and Knowledge of Arboviral Diseases in Cities with Differing Recent History of Disease

Effects of climate change and human activities on vector-borne diseases

Vector-borne diseases are transmitted by haematophagous arthropods (for example, mosquitoes, ticks and sandflies) to humans and wild and domestic animals, with the largest burden on global public health disproportionately affecting people in tropical and subtropical areas. Because vectors are ectothermic, climate and weather alterations (for example, temperature, rainfall and humidity) can affect their reproduction, survival, geographic distribution and, consequently, ability to transmit pathogens. However, the effects of climate change on vector-borne diseases can be multifaceted and complex, sometimes with ambiguous consequences. In this Review, we discuss the potential effects of climate change, weather and other anthropogenic factors, including land use, human mobility and behaviour, as possible contributors to the redistribution of vectors and spread of vector-borne diseases worldwide.

A review of knowledge, attitudes and practices regarding mosquitoes and mosquito-borne infectious diseases in nonendemic regions

Mosquito-borne infectious diseases (MBIDs) present significant public health risks within tropical and subtropical regions. However, the rapid spread of MBIDs from these areas to temperate regions increase the risk of their emergence in nonendemic regions, i.e., regions where diseases are still sporadic and not sustained in the population. Raising awareness about preventive measures and protective behaviors is of primary importance to face the risks of vector-borne diseases. In this context, the number of studies on knowledge, attitude, and practice (KAP) about mosquitoes and MBIDs has grown rapidly in response to the need to identify knowledge and practices in nonendemic countries to fight mosquito proliferation. Building upon the recent developments in this field, we conducted the first-ever literature review to examine KAP studies conducted in nonendemic regions. Our aim was to identify the community's knowledge and attitudes that shape practices concerning the prevention of MBIDs. We used specific keywords regarding the scope of this review and then selected studies that were performed in nonendemic regions for MBIDs, including regions located in European countries, the USA or Asia. We identified 32 KAP studies, the oldest from 2003. The findings in the reviewed studies show that survey participants generally possessed a rather good understanding of mosquito breeding sites. However, there were notable variations in knowledge and perception of MBIDs, primarily linked to the geographic location of the survey and the prevalence of infectious outbreaks related to mosquito transmission. These findings highlight the significant influence of knowledge and awareness in fostering effective mosquito control practices. Moreover, socioeconomic status, particularly educational attainment, and respondents' gender emerged as key determinants in explaining the variability of appropriate practices. The survey results thus show the crucial role of knowledge, emphasizing the need for widespread awareness and information campaigns, encompassing both appropriate practices and efficient mosquito control methods. Understanding the interaction between these factors could provide good guidelines for implementing awareness plans and ultimately motivate the population to actively fight against mosquito proliferation and MBIDs development.

A Survey on Mosquito Control Knowledge and Insecticide Use in New Orleans, La, 2020-2021

Mosquitoes are a known public nuisance and can vector various diseases. Historically, New Orleans, LA, has long been acquainted with the burden of mosquito-borne diseases, such as malaria and yellow fever in the 20th century and West Nile virus in the 21st century. Government mosquito control awareness campaigns have been around for decades as has the use of organophosphate and pyrethroid insecticides by mosquito abatement districts. However, few data are available on public perception of mosquito control and public usage of insecticides to kill mosquitoes in New Orleans. We conducted a survey from August 2020 to July 2021 to evaluate New Orleans residents' 1) general knowledge regarding mosquito control and 2) what measures and products they use to control mosquitoes. The aim of this survey was to determine how residents contribute to backyard mosquito control by do-it-yourself or professional applications of insecticides. The survey was disseminated both online and via mail. Of the 396 survey participants, nearly all (99.48%) agreed that mosquito control is important in New Orleans because it prevents mosquito bites (30.85%), prevents mosquito borne-diseases (38.51%), and prevents nuisance mosquitoes (29.17%). More than one-third (35%) of survey participants indicated that they empty containers to reduce adult mosquitoes on their own property. More than two-thirds of the participants (69.95%) would not hire a pest management professional to spray their yard for adult mosquitoes, and only 20% of survey participants do apply a pesticide to kill adult mosquitoes on their own property. None of our findings were associated with the level of education, gender, or age of participants. This study suggests that the City of New Orleans Mosquito, Termite and Rodent Control Board educational and outreach campaigns may be an effective tool in spreading mosquito control awareness and contribute to residents' knowledge of mosquito control. The data we collected indicate that residents understand what mosquito control is and why it is important in New Orleans.

Personality and city culture predict attitudes and practices toward mosquitoes and mosquito-borne diseases in South Texas

Personality is known to affect compliance with health-protective behaviors and it has been shown that effective public health messaging can be informed by an understanding of that relationship. Thus, we aimed to evaluate the role personality might play in implementing personal protective measures (PPMs) that can prevent mosquito-borne diseases. This is the first mosquito-related knowledge, attitudes, and practices (KAP) study to incorporate a measure of personality using the Big Five: openness, conscientiousness, extraversion, agreeableness, and neuroticism. KAP studies in Gulf-coast and Mexican border-states in the U.S. are few. Ours is only the second KAP study to take place in Texas despite known local transmission and established mosquito populations capable of transmitting dengue, zika, chikungunya, and West Nile viruses. The KAP survey was administered in three neighborhoods in San Antonio, a large, Hispanic-majority, urban city that is segregated economically and ecologically. We found that openness, agreeableness, and extraversion predicted certain attitudes and PPMs, and that KAP and personality measures did not differ along ethnic or neighborhood lines. Perceptions toward the city's role in mosquito control and education was an important factor in predicting PPMs, suggesting that city culture (attitudes common throughout the city as opposed to attitudes differing by ethnicity and neighborhood) may be most salient in developing public health messaging in San Antonio.

Do health risk perceptions motivate water - and health-related behaviour? A systematic literature review

Health-related risk perceptions are important determinants of health behaviours and components of behaviour change theories. What someone thinks or feels will motivate or hinder their intention or hesitancy to implement a certain behaviour. Thus, a perceived potential risk to our health and well-being can influence our health-promoting and/or health-seeking behaviour. We aimed to review and synthesize available peer-reviewed literature to better understand the links between water and health-related risk perceptions and behaviours. We conducted the first systematic review of peer-reviewed literature on risk perceptions and behaviours in the context of water and health, published between 2000 and 2021. A total of 187 publications met the inclusion criteria. We extracted data relating to study characteristics and categorized our results according to the major themes emerging from the literature, namely drinking water, sanitation, hygiene and wasterelated topics, health risk factors, diseases and mental health implications, and preventative measures. Our review shows that the literature has grown over the past twenty years, reporting information from different countries belonging to different income groups around the globe, conducted in various settings and contexts, among different target populations, from various disciplinary angles, using different methods, theories and approaches. Our review provides evidence of health risk perceptions determining behaviour particularly related to drinking water sources and water safety. Evidence on disease prevention, health seeking, variations and changes in perception and behaviour over space, geography, socioeconomic differences and time, and the relevance of cultural context is provided. Our review shows that risk perception studies are vital for WASH governance in terms of policy, raising awareness, education and behaviour change. In order to make risk perception and behaviour studies even more relevant to effective public health planning and health messaging, future research needs to increasingly focus on early culturally sensitive interventions and changes in perceptions and behaviours over time.

Taking the Bite out of Mosquito Bites: The Role of Perceived Risk

The present study examined how dimensions of perceived risk contributed to mosquito avoidance behaviors in a flood-prone area. Mosquito avoidance behaviors were classified into proactive (i.e. used repellant sources) and withdrawal/reactive (i.e. reduced outside activities) behaviors. After controlling for level of mosquito bites, increased scores for above normal perceived risk were associated with withdrawal/reactive avoidance behaviors; whereas, increased scores for normal perceived risk were associated with proactive avoidance behaviors. Efforts to improve mosquito avoidance behaviors should distinguish the type of perceived risk and the type of avoidance behavior. Greater congruence between perceived risk (i.e. normal risk of mosquito-borne illnesses) and avoidance behaviors (i.e. planning avoidance behaviors) will increase the effectiveness of education programs for disease prevention.

Human-Mosquito Contact: A Missing Link in Our Understanding of Mosquito-Borne Disease Transmission Dynamics

Despite the critical role that contact between hosts and vectors, through vector bites, plays in driving vector-borne disease (VBD) transmission, transmission risk is primarily studied through the lens of vector density and overlooks host-vector contact dynamics. This review article synthesizes current knowledge of host-vector contact with an emphasis on mosquito bites. It provides a framework including biological and mathematical definitions of host-mosquito contact rate, blood-feeding rate, and per capita biting rates. We describe how contact rates vary and how this variation is influenced by mosquito and vertebrate factors. Our framework challenges a classic assumption that mosquitoes bite at a fixed rate determined by the duration of their gonotrophic cycle. We explore alternative ecological assumptions based on the functional response, blood index, forage ratio, and ideal free distribution within a mechanistic host-vector contact model. We highlight that host-vector contact is a critical parameter that integrates many factors driving disease transmission. A renewed focus on contact dynamics between hosts and vectors will contribute new insights into the mechanisms behind VBD spread and emergence that are sorely lacking. Given the framework for including contact rates as an explicit component of mathematical models of VBD, as well as different methods to study contact rates empirically to move the field forward, researchers should explicitly test contact rate models with empirical studies. Such integrative studies promise to enhance understanding of extrinsic and intrinsic factors affecting host-vector contact rates and thus are critical to understand both the mechanisms driving VBD emergence and guiding their prevention and control.

Knowledge, Attitudes, and Practices Related to Rocky Mountain Spotted Fever in Hermosillo, México

Rocky Mountain spotted fever (RMSF) is a serious disease in northwest Mexico, particularly in low-income communities. This study aimed to evaluate RMSF-related knowledge, attitudes, and practices in an endemic urban area with a high burden of the disease. A cross-sectional study design using a non-probabilistic household survey was conducted with 400 residents in Hermosillo, Mexico. Primary themes assessed included dog and tick-related exposure, RMSF knowledge, healthcare-seeking behavior, sociodemographic data, and household information. The majority (59%) of those surveyed had heard about RMSF, although only 36% of RMSF-aware respondents knew any RMSF symptoms. Among RMSF-aware respondents, 26% did not know or were unsure of prevention strategies. Individuals in the low socioeconomic status (SES) stratum were less likely to have heard about RMSF (odds ratio [OR]: 0.39; 95% CI: 0.25-0.59), use dog collars or any other product to avoid ticks (OR: 0.40; 95% CI: 0.17-0.99), or check their dogs for ticks (OR: 0.25; 95% CI: 0.09-0.74). The likelihood of observing high numbers of free-roaming dogs in their neighborhood was four times higher in the low SES stratum (OR: 4.19; 95% CI: 2.10-8.38) than in the high SES stratum. These findings emphasize the need for an integrative community approach to improve early recognition of symptoms and knowledge of prevention strategies, particularly in low SES neighborhoods.

An Investigation of Human-Mosquito Contact Using Surveys and Its Application in Assessing Dengue Viral Transmission Risk

Aedes-borne viral diseases such as dengue fever are surging in incidence in recent years. To investigate viral transmission risks, the availability of local transmission parameters is essential. One of the most important factors directly determining infection risk is human-mosquito contact. Yet the contact rate is not often characterized, compared with other risk metrics such as vector density, because of the limited research tool options. In this study, human-mosquito contact was assessed in two study sites in the Southern United States using self-administered standardized survey instruments. The fraction of mosquito bites attributed to important vector species was estimated by human landing sampling. The survey participants reported a significantly higher outdoor mosquito bite exposure than indoor. The reported bite number was positively correlated with outdoor time during at-risk periods. There was also a significant effect of the study site on outdoor bite exposure, possibly due to the differing vector density. Thus, the levels of human-mosquito contact in this study were influenced both by the mosquito density and human behaviors. A dengue virus transmission model demonstrated that the observed difference in the contact rates results in differential virus transmission risks. Our findings highlight the practicality of using surveys to investigate human-mosquito contact in a setting where bite exposure levels differ substantially, and serve as a basis for further evaluations. This study underscores a new avenue that can be used in combination with other field methods to understand how changes in human behavior may influence mosquito bite exposure which drives mosquito-borne virus transmission.

Emerging arboviruses (dengue, chikungunya, and Zika) in Southeastern Mexico: influence of socio-environmental determinants on knowledge and practices

The proliferation of arboviruses and their vectors is influenced by a complex interplay between vector, environment and human behaviors. The aim of this work is to analyze the influence of socio-environmental determinants on knowledge and practices regarding arboviruses transmission, among the residents of three communities on the southern border of Mexico. Between June 2017 and August 2018, a set of 149 households from three communities of Tapachula (Chiapas) and Villahermosa (Tabasco) were covered. This study consists of the application of a community prevention project. Different surveys and methodological approaches were used. Associations between socio-environmental determinants and knowledge and practices for arboviruses transmission control were estimated by odds ratio. Logistic regression and qualitative techniques were used. Although around 75% of households had an adequate knowledge about arboviruses' origin and transmission, only 30% of them adopted adequate practices. Domestic risk practices were associated with serious deficiencies in water and sanitation services. Furthermore, a perception of greater risk and difficulty in complying with preventive measures were detected. An adequate knowledge does not necessarily lead to adequate prevention practices. Intermediate social determinants influence on the persistence of risk behaviors for arboviruses proliferation. Addressing such related aspects requires the achievement of an effective and sustainable vector management.

Public perceptions of non-pharmaceutical interventions for influenza and mosquito-borne illnesses - a statewide survey in Arizona

AIMS

We conducted a statewide online survey to understand public knowledge, attitudes, and practices (KAP) related to non-pharmaceutical interventions (NPIs) for mosquito-borne diseases and influenza in Arizona.

METHODS

The survey included knowledge of diseases, major health concerns, and sources of health information and KAP of NPIs for influenza and mosquito-borne diseases. Our team worked with Qualtrics^®, an online survey company, to recruit a representative sample of 1500 adults in Arizona.

RESULTS

Of the 1531 respondents who completed the survey, most indicated that chronic conditions were their primary health concern (48%), with the other half split between infectious diseases (25%) and health effects of environmental conditions (26%). The majority (88%) of respondents indicated that they use the Internet to get their health information. Approximately one in eight people reported not emptying standing water and reducing potential mosquito habitats, despite respondents citing them as being the most effective factors in reducing mosquitoes. Regarding specific diseases, about half of the respondents were concerned about West Nile virus and/or Zika virus. Most (85%) people knew the signs and symptoms of influenza and 63% of people reported being likely to get the influenza shot. Those who did not vaccinate (n = 285) reported concerns that the vaccine would make them sick (41%), was ineffective (37%), or others indicated, 'I don't want to' (37%).

CONCLUSIONS

Overall, respondents were most concerned with chronic conditions and received their information from the Internet. Knowledge about mosquito-borne diseases was low. There were high levels of acceptance and self-reported uptake of the influenza vaccine.

Socioeconomic and Human Behavioral Factors Associated With Aedes aegypti (Diptera: Culicidae) Immature Habitat in Tucson, AZ

Aedes aegypti (L.; Diptera: Culicidae) has been established in the southwestern United States for several decades, but relationships between humans and mosquitoes in this arid region are not well-characterized. In August 2012, the outdoor premises of 355 houses within 20 neighborhoods in Tucson, Arizona were surveyed for containers that could provide larval habitat for Ae. aegypti mosquitoes. At the same time, a knowledge, attitudes and practices (KAP) questionnaire was administered to a resident of each house surveyed for immature mosquitoes. The KAP questionnaire assessed respondents' knowledge and concerns about vector-borne illnesses as well as practices they used to avoid mosquitoes. Of the houses surveyed, 91% had at least one container present, and 64% had at least one container with standing water. On average, each house had 2.2 containers with water at the time of the survey. The overall House Index (proportion of premises surveyed with at least one container with Ae. aegypti immatures present) was 13%. Based on questionnaire responses, there was a significant positive association between the number of residents in the home and the odds of finding Ae. aegypti positive containers on the premises, while household income showed a significant negative association. The reported frequency of checking for standing water was also significantly associated with the odds of finding immatures, although the nature of this association was ambiguous. Flower pots were the principal type of container with Ae. aegypti larvae. These findings show that larval habitat is widely available even in an arid environment and city with good housing and sanitation infrastructure.

Regional Survey of Mosquito Control Knowledge and Usage In North Carolina

Mosquitoes are a nuisance and can transmit pathogens to humans and other animals, resulting in notable morbidity and mortality. Organized mosquito control programs conduct surveillance, source reduction, treatment of mosquito oviposition sites, and adulticiding to protect public health. However, in some regions, there has been a decline in county and municipal mosquito control programs, and homeowners increasingly contract with private mosquito control companies or address mosquito-related issues themselves at the household level. The extent to which these services are being used, the potential for mosquito and/or insecticide exposure around the home, and the access to these services by individuals of different socioeconomic categories are not known. We conducted regional (western, central, eastern) assessments of public perception and knowledge of mosquito control services in a variety of communities of different socioeconomic categories (low, moderate, high) and types (urban, suburban, rural) in 3 North Carolina counties. We also assessed the respondents' basic knowledge of mosquito-borne diseases. Most respondents thought mosquito control was important to protect against both nuisance mosquitoes and mosquito-borne disease. The majority of people would pay ≤$50/year for mosquito control and most thought this should be covered by municipal/county taxes. Many respondents (31%, 95% confidence interval [CI] 26-35%) personally undertake mosquito control on their properties, but only 5.3% (95% CI 3.1-7.5%) contract with professional mosquito control services, with no significant differences between region, community type, or socioeconomic category in the proportion using private mosquito control services. While there were significant differences between factor levels (3 regions, 3 community types, 3 socioeconomic categories) in some responses, there were no significant differences observed between respondents, regardless of factor level, in the willingness to contribute funds to a community-based mosquito control program.