Personal-protection measures against mosquitoes: a study of practices and costs in a district, in the Indian state of Orissa, where malaria and lymphatic filariasis are co-endemic.

In a study undertaken among rural and urban communities in a district of Orissa, India, the personal-protection measures used against mosquitoes, and the household costs of these measures, were investigated. Most people living in the study communities perceived mosquitoes as a problem, both as a biting nuisance and as vectors of human disease. Almost all (99%) of the urban households investigated and most (84%) of the rural each reported the use of at least one measure against mosquitoes. Most of the study households (92% of the urban and 64% of the rural) used a 'modern' chemical method (coils, vaporizing mats, liquid vaporizers or sprays), with mosquito coils used more frequently than any other personal-protection measure. Untreated bednets were also used by most of the households investigated (76% of the urban and 58% of the rural) and some households (about 10% of the urban and 8% of the rural) still used the more traditional method of burning dried dung or vegetation indoors, specifically to create smoke to drive away mosquitoes. Setting, house type, as indicated by the material used as roofing, and number of people in the household were each a significant predictor of the use of personal protection, with households in an urban setting, large households, and households occupying a concrete-roofed building relatively more likely to use some form of personal protection. Although 'modern', chemical-based methods were frequently employed, about one in every two interviewees (57% of the urban and 43% of the rural) considered the use of such methods to be harmful to their health. The mean monthly expenditures on personal-protection measures were 101 Indian rupees (U.S.$2.20)/urban household and 72 Indian rupees (U.S.$1.60)/rural household. Setting, family income, family size and number of sleeping rooms in the house each affected such expenditure significantly. As a proportion of household income, expenditure on controlling mosquitoes was surprisingly high.