title: Acceptability and perceived side effects of insecticide indoor residual spraying under different resistance management strategies.
abstract: OBJECTIVE
  To assess household acceptability and perceived side effects of residual indoor pyrethroid (PYR), carbamate and organophosphate insecticides sprayed by annual rotation (ROT), spatial mosaic (MOS), and a single insecticide (DDT or PYR) in communities of the coastal plain of Chiapas, Mexico.
  
  
  METHODS
  A questionnaire to assess the acceptability and perceived side effects of indoor insecticides was administered to one member of 30% of the families in eight villages of Chiapas. The association of different insecticide treatments with their responses was evaluated (Chi-square). The intensity of side effects indicated under different treatments was compared in an ordered logistic model, using a severity index as the response variable.
  
  
  RESULTS
  Insecticide spraying as a probable cause of symptoms was identified by 2.1% of interviewees. A significantly high percentage of persons with blurred vision, dizziness, sneezing, coughing, numbness, watery eyes, and itching lived in villages under MOS and ROT and a high severity index was significantly associated with ROT treatment. Reduction of mosquito bites and cockroaches were the perceived main benefits, and most villagers that perceived no benefits lived in DDT treated villages. Most of the interviewees welcomed spraying (83.7%), but the smell and having to remove furniture from houses were the main arguments against it.
  
  
  CONCLUSIONS
  Acceptability correlated with insecticide spray coverage, although the most frequent suggestion for improvement was to increase the understanding of the objectives of spraying in the communities. The frequency of side effects was low, but higher in localities where a combination of insecticides was applied. This is a limitation for the use of this type of resistance management strategy in public health.
authors.affiliation: Centro de Investigación de Paludismo, Instituto Nacional de Salud Pública, Tapachula, Chiapas, México. mhenry@insp.mx
authors.forename: Américo David
authors.initials: AD
authors.lastname: Rodríguez
authors.forename: Rosa Patricia
authors.initials: RP
authors.lastname: Penilla
authors.forename: Mario Henry
authors.initials: MH
authors.lastname: Rodríguez
authors.forename: Janet
authors.initials: J
authors.lastname: Hemingway
authors.forename: Antonio
authors.initials: A
authors.lastname: Trejo
authors.forename: Juan Eugenio
authors.initials: JE
authors.lastname: Hernández-Avila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D005192:Family Health; D005260:Female; D005651:Fumigation / Q000009:adverse effects*; D006801:Humans; D007306:Insecticides / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010465:Perception; D011795:Surveys and Questionnaires
chemical_list: D007306:Insecticides