To spray or not to spray? Understanding participation in an indoor residual spray campaign in Arequipa, Peru

Abstract

Current low participation rates in vector control programmes in Arequipa, Peru complicate the control of Chagas disease. Using focus groups (n = 17 participants) and semi-structured interviews (n = 71) conducted in March and May 2013, respectively, we examined barriers to and motivators of household participation in an indoor residual spray (IRS) campaign that had taken place one year prior in Arequipa. The most common reported barriers to participation were inconvenient spray times due to work obligations, not considering the campaign to be necessary, concerns about secondary health impacts (e.g. allergic reactions to insecticides), and difficulties preparing the home for spraying (e.g. moving heavy furniture). There was also a low perception of risk for contracting Chagas disease that might affect participation. The main motivator to participate was to ensure personal health and well-being. Future IRS campaigns should incorporate more flexible hours, including weekends; provide appropriate educational messages to counter concerns about secondary health effects; incorporate peer educators to increase perceived risk to Chagas in community; obtain support from community members and leaders to build community trust and support for the campaign; and assist individuals in preparing their homes. Enhancing community trust in both the need for the campaign and its operations is key.

Determinants of intentions to prevent triatomine infestation based on the health belief model: An application in rural southern Ecuador

“…In addition to community members, these educational interventions can include professional home inspectors [52] and physicians [53,54]. Although the causal mechanism is rarely explained, researchers argue that, if individuals become more aware of the severity of CD and their susceptibility to the disease, they will be more likely to seek preventive measures [55][56][57]. This focus on training and home inspection is supported by the initial regression solution in this study.…”

Barriers that limit the implementation of thermal fogging for the control of dengue in Colombia: a study of mixed methods

“…Palma-Pinedo [18] reported that one of the main problems in vector control is that scheduled treatments do not conform to the routines of families. Particularly, residents who work far from home can't be present when vector control activities normally take place [34,35]. As SSM fumigation is performed on weekdays and during working hours, it is possible that the proportion of closed houses observed in this study can be explained by this factor [18,35].…”

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

“…Studies of household insecticide use and community fumigation in Peru have historically focused on the chemical control of vector-borne disease targeting mosquitoes and triatomines (1)(2)(3)(4)(5)(6)(7). Household insecticides can present a serious health risk for household members, particularly children (8,9).…”

“…Household insecticide use and uptake of insecticide campaigns in Peru has been studied predominantly in response to serious health threats from vector-borne disease (1-3, 5, 6, 10). In Arequipa and surrounding areas where the current study was conducted, insecticide research efforts have focused particularly on addressing triatomine, or "kissing bug," populations in response to Chagas disease (1,(11)(12)(13)(14). One residential insecticide spray campaign in peri-urban Arequipa in 2012 reached only 66% of homes, and a study found that primary reported barriers included practical concerns such as spray times coinciding with work obligations and difficulties preparing the home, as well as concerns about the health impacts of insecticides and a perception that the campaign was not necessary (1).…”

“…In Arequipa and surrounding areas where the current study was conducted, insecticide research efforts have focused particularly on addressing triatomine, or "kissing bug," populations in response to Chagas disease (1,(11)(12)(13)(14). One residential insecticide spray campaign in peri-urban Arequipa in 2012 reached only 66% of homes, and a study found that primary reported barriers included practical concerns such as spray times coinciding with work obligations and difficulties preparing the home, as well as concerns about the health impacts of insecticides and a perception that the campaign was not necessary (1). Though unreported in that publication, one of the less reported comments from household members refusing spraying was that they had used some form of vector control product on their own, which led to our concern about types and amounts of insecticide that might be in use in this region.…”