Misuse, perceived risk, and safety issues of household insecticides: qualitative findings from focus groups in Arequipa, Peru

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 insecticide 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 an activity in which participants advertised insecticides (physically available during the FGD) to elicit perceptions of currently available insecticides. 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 There was not consensus on a preferred form, strength, or brand of insecticides; valued characteristics such as strength and effectiveness were often associated with negative characteristics such as odor and health impacts. The perceived risks associated with insecticides included both short- and long-term health impacts, and safety for children emerged as a priority. However, some participants reported applying insecticides directly to children and their beds. Some participants attempted to reduce the risk of insecticide use with informal, and likely ineffective, personal protective equipment and by timing application when household members were away. “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.