Modeling Insect-Repellent Use for Chikungunya Disease Prevention Among US-Caribbean Travelers

Oghenekaro Omodior,Brijesh Thapa,Lori Pennington-Gray

doi:10.15171/ijtmgh.2017.25

Abstract

Introduction: This study examined the relationship between specific psychosocial variables and the use of insect repellents on skin or clothing as a preventive behavior for Chikungunya fever among US travelers to Caribbean destinations. Methods: A cross-sectional retrospective online survey method was adopted. US residents who travelled to one of 34 Caribbean destinations within the past 12 months and expressed an awareness of Chikungunya fever were invited to participate in this study. Sociodemographic variables, perceived response efficacy, perceived self-efficacy, perceived Chikungunya severity and susceptibility, and self-reported use of insect repellents were investigated. Results: Results of direct logistic regression analysis revealed a significant association between higher levels of education and the odds of self-reported use of insect repellent on skin or clothing among study participants. Among the proximal Chikungunya-related variables, hierarchical binary logistic regression revealed a significant association between scores on perceived response efficacy, perceived self-efficacy, and perceived severity of self-reported use of insect repellents. These results support the existence of a hierarchical relationship between the more proximal Chikungunya-related variables and self-reported use of insect repellents as a personal protective measure (PPM). Conclusion: The findings of the current study have important implications for health communication messaging aimed at reducing the spread of Chikungunya among US travelers to Caribbean destinations. It seems essential to establish the use of insect repellent on skin and clothing as a personal preventive measure against Chikungunya disease within an educational context, framed along the lines of Chikungunya severity, response efficacy, and self-efficacy, for US travelers to destinations with a high risk of exposure to Chikungunya disease-carrying mosquitoes.

Highlights

Introduction: This study examined the relationship between specific psychosocial variables and the use of insect repellents on skin or clothing as a preventive behavior for Chikungunya fever among US travelers to Caribbean destinations
It seems essential to establish the use of insect repellent on skin and clothing as a personal preventive measure against Chikungunya disease within an educational context, framed along the lines of Chikungunya severity, response efficacy, and self-efficacy, for US travelers to destinations with a high risk of exposure to Chikungunya disease-carrying mosquitoes
Beginning in 2014, soon after the disease appeared in Caribbean destinations, the United States saw an increase in Chikungunya cases among travelers returning from the Caribbean and South America, with nearly 3000 travelrelated cases reported nationwide

Summary

Introduction

This study examined the relationship between specific psychosocial variables and the use of insect repellents on skin or clothing as a preventive behavior for Chikungunya fever among US travelers to Caribbean destinations. Beyond the immediate infection risk to individual US travelers to disease endemic regions is an even wider public health risk resulting from the possibility for local transmission and/or epidemic events due to [1] the absence of pre-existing protective immunity in the general population, [2] a high viral load in the host and infected vectors, and [3] the wide distribution of the Aedes aegypti and Aedes albopictus mosquitoes in the United States, Omodior et al especially along the southern, western, and eastern seaboards of the United States.3,4,7 It is not surprising, that despite the disease being under-reported and underrecognized, about 5000 cases of autochthonous transmission were reported in the US territories of Puerto Rico, US Virgin Islands, and American Samoa.. States among travelers returning from areas known to be epidemic or endemic for Chikungunya disease. beginning in 2014, soon after the disease appeared in Caribbean destinations, the United States saw an increase in Chikungunya cases among travelers returning from the Caribbean and South America, with nearly 3000 travelrelated cases reported nationwide. Beyond the immediate infection risk to individual US travelers to disease endemic regions is an even wider public health risk resulting from the possibility for local transmission and/or epidemic events due to [1] the absence of pre-existing protective immunity in the general population, [2] a high viral load in the host and infected vectors, and [3] the wide distribution of the Aedes aegypti and Aedes albopictus mosquitoes in the United States, Omodior et al especially along the southern, western, and eastern seaboards of the United States. It is not surprising, that despite the disease being under-reported and underrecognized, about 5000 cases of autochthonous transmission were reported in the US territories of Puerto Rico, US Virgin Islands, and American Samoa. Autochthonous Chikungunya cases were reported in Florida in 2014,4 prompting health authorities in the United States to brace for the wider spread of the disease.

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Conclusion