title: The use of mosquito repellents at three sites in India with declining malaria transmission: surveys in the community and clinic.
abstract: Repellents such as coils, vaporizers, mats and creams can be used to reduce the risk of malaria and other infectious diseases. Although evidence for their effectiveness is limited, they are advertised as providing an additional approach to mosquito control in combination with other strategies, e.g. insecticide-treated nets. We examined the use of repellents in India in an urban setting in Chennai (mainly Plasmodium vivax malaria), a peri-urban setting in Nadiad (both P. vivax and P. falciparum malaria), and a more rural setting in Raurkela (mainly P. falciparum malaria).
  
  
  
  The use of repellents was examined at the household level during a census, and at the individual level in cross-sectional surveys and among patients visiting a clinic with fever or other symptoms. Factors associated with their use were examined in a multivariate analysis, and the association between malaria and the use of repellents was assessed among survey- and clinic participants.
  
  
  
  Characteristics of participants differed by region, with more people of higher education present in Chennai. Use of repellents varied between 56-77 % at the household level and between 32-78 % at the individual level. Vaporizers were the main repellents used in Chennai, whereas coils were more common in Nadiad and Raurkela. In Chennai and Nadiad, vaporizers were more likely to be used in households with young male children. Vaporizer use was associated with higher socio-economic status (SES) in households in Chennai and Nadiad, whereas use of coils was greater in the lower SES strata. In Raurkela, there was a higher use of coils among the higher SES strata. Education was associated with the use of a repellent among survey participants in Chennai and clinic study participants in Chennai and Nadiad. Repellent use was associated with less malaria in the clinic study in Chennai and Raurkela, but not in the surveys, with the exception of the use of coils in Nadiad.
  
  
  
  Repellents are widely used in India. Their use is influenced by the level of education and SES. Information on effectiveness and guidance on choices may improve rational use.
authors.affiliation: Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA. amvaneijk@gmail.com.
authors.forename: Anna Maria
authors.identifier: 0000-0003-1635-1289
authors.initials: AM
authors.lastname: van Eijk
authors.affiliation: Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.
authors.forename: Lalitha
authors.initials: L
authors.lastname: Ramanathapuram
authors.affiliation: Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.|Acsel Health, 500 5th Ave, Suite 2760, New York, NY, 10110, USA.
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Sutton
authors.affiliation: Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Raurkela, Odisha, India.
authors.forename: Nandini
authors.initials: N
authors.lastname: Peddy
authors.affiliation: Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Raurkela, Odisha, India.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Choubey
authors.affiliation: Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Raurkela, Odisha, India.
authors.forename: Stuti
authors.initials: S
authors.lastname: Mohanty
authors.affiliation: National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India.
authors.forename: Aswin
authors.initials: A
authors.lastname: Asokan
authors.affiliation: National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India.
authors.forename: Sangamithra
authors.initials: S
authors.lastname: Ravishankaran
authors.affiliation: National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India.
authors.forename: G Sri Lakshmi
authors.initials: GS
authors.lastname: Priya
authors.affiliation: National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India.
authors.forename: Justin Amala
authors.initials: JA
authors.lastname: Johnson
authors.affiliation: National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India.
authors.forename: Sangeetha
authors.initials: S
authors.lastname: Velayutham
authors.affiliation: National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India.
authors.forename: Deena
authors.initials: D
authors.lastname: Kanagaraj
authors.affiliation: National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India.
authors.forename: Ankita
authors.initials: A
authors.lastname: Patel
authors.affiliation: National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India.
authors.forename: Nisha
authors.initials: N
authors.lastname: Desai
authors.affiliation: National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India.
authors.forename: Nikunj
authors.initials: N
authors.lastname: Tandel
authors.affiliation: Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Sullivan
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Wassmer
authors.affiliation: National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India.
authors.forename: Ranveer
authors.initials: R
authors.lastname: Singh
authors.affiliation: Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Raurkela, Odisha, India.
authors.forename: K
authors.initials: K
authors.lastname: Pradhan
authors.affiliation: Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Carlton
authors.affiliation: National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India.
authors.forename: H C
authors.initials: HC
authors.lastname: Srivasatava
authors.affiliation: National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India.
authors.forename: Alex
authors.initials: A
authors.lastname: Eapen
authors.affiliation: National Institute of Malaria Research, Indian Council of Medical Research, Dwarka Sector 8, New Delhi, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D005334:Fever / Q000469:parasitology; D006801:Humans; D007194:India / Q000453:epidemiology; D007302:Insect Repellents / Q000009:adverse effects; D008288:Malaria / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control* / Q000635:transmission*; D016778:Malaria, Falciparum / Q000469:parasitology / Q000517:prevention & control*; D016780:Malaria, Vivax / Q000469:parasitology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods / Q000706:statistics & numerical data; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data; D012424:Rural Population; D012923:Social Class; D014505:Urban Population; D055815:Young Adult
chemical_list: D007302:Insect Repellents
keywords: Education; Mosquito control; Plasmodium falciparum; Plasmodium vivax; Repellents; Rural; Socio-economic status; Urban