the vector - borne diseases especially those spread through mosquitoes constitute an important cause of morbidity and mortality . in recent years
, mosquito - borne diseases have emerged as a serious public health problem in countries of south east asia region ( sear ) including india .
indian scenario is bad as more than three - fourth of population lives in malaria risk areas with 1.86 million disability adjusted life years ( dalys ) lost annually .
similarly , dengue which is endemic in around 112 countries worldwide is on a rising trend affecting mainly urban areas of tropical and subtropical regions with about 2.5 billion people at risk of acquiring infection and indian metropolitan cities and towns are no exception [ 24 ] .
to make the situation even worse in india , chikungunya , japanese encephalitis , and filariasis outbreaks occur from time to time almost throughout the country . to achieve effective control of mosquito - borne diseases , general public health measures have to be instituted
the use of personal protective measures ( ppm ) like mats , bed nets , screening , repellents , liquid vaporizers , mosquito coils , and so forth has been advocated as an effective tool in control of mosquito - borne diseases . but
animal and some human studies have shown ill effects of personal protective measures [ 57 ] . keeping the above aspects in view ,
this study was planned with an objective to study the usage and perceived side effects of personal protective measures used against mosquitoes among current users in delhi .
this was a community - based cross - sectional study conducted in a rural area , barwala located in northwest district , and an urban slum , balmiki basti situated in central district in delhi .
the sampling universe included all adult individuals ( more than or equal to 18 years ) residing in the above - mentioned areas .
sample size was calculated on the basis of results of a previous study where usage of personal protective measures was 54% .
the study sample included 210 individuals from rural area and 140 from urban area ( total of 350 adult individuals ) selected as per proportion to population size .
the study was carried out over a period of 1 year from january to december 2012 .
data was collected by interviewing the study subjects , after getting written informed consent , using a pretested semistructured interview schedule in the local language .
the schedule contained items on socioeconomic and demographic profile of study subjects , usage and perceived side effects of personal protective measures against mosquitoes among users .
every effort was made to interview the head of the family . in case head of the family
was not available , then any person more than 18 years of age was selected using lottery method . when house was found locked even after three visits ,
chi - square test / fisher 's exact test was used for finding an association between qualitative variables and p value less than 0.05 was considered significant .
as shown in table 1 , 147 ( 42% ) subjects were males and 203 ( 58% ) were females .
108 ( 51.4% ) subjects in rural and 55 ( 39.3% ) in urban area belonged to 1829 years of age group ; 59 ( 28.1% ) in rural and 41 ( 29.3% ) in urban area belonged to 3039 years of age group .
51 ( 24.3% ) subjects in rural area and 33 ( 23.6% ) in urban area were illiterate .
those educated up to middle school were 46 ( 21.9% ) in rural and 30 ( 21.4% ) in urban area .
in rural area , 50 ( 23.8% ) subjects were unskilled workers but , in urban area , 39 ( 27.9% ) of subjects were semiskilled workers .
3824.84  2308.41 ( sd ) and 2846.92  1708.12 ( sd ) in urban area which ranged from rs . 1000 to 15,000 in rural and rs . 666 to 10,000 in urban area
study subjects reported use of more than one method for personal protection in their families .
87 ( 41.4% ) families in rural area and 63 ( 45.0% ) in urban areas were using one ppm against mosquitoes .
31 ( 14.8% ) in rural and 18 ( 12.8% ) in urban area reported use of 2 different personal protective methods .
14 ( 6.7% ) in rural and 6 ( 4.3% ) in urban area were using 3 or more ppm .
78 ( 37.1% ) subjects in rural and 53 ( 37.8% ) subjects in urban area reported that they were not using any ppm . 

table 2 shows results of use of personal protective measures against mosquitoes among study subjects . in both rural and urban areas ,
liquid vaporizers were the most preferred method ( 41.4% ) , 46.7% subjects in rural and 33.6% in urban area ( p = 0.01 ) .
the second most common method was coils , used by 44 ( 21.0% ) in rural and 42 ( 30.0% ) in urban area ( p = 0.05 ) . 

table 3 shows perceived side effects of different personal protective measures . the most common side effect was headache reported by 17 ( 7.7% ) subjects .
other perceived side effects were cough ( 3.2% ) , sore throat ( 2.7% ) , allergy ( 1.3% ) , and eye irritation ( 0.9% ) predominantly among coil users . among those using coils , 11 ( 12.8% ) reported headache , 7 ( 8.1% ) cough , 5 ( 5.8% ) sore throat , 2 ( 2.3% ) allergy , 2 ( 2.3% ) eye irritation and 1 ( 1.2% ) rashes .
liquid vaporizers were associated with headache 5 ( 3.4% ) and sore throat 1 ( 0.7% ) .
in the present study , the most preferred method in both rural ( 46.7% ) and urban areas ( 33.6% ) was liquid vaporizer .
these figures are low as compared to a study done in kerala which found that most ( 80.0% ) of the rural and all of the urban households reported using at least one personal protective measure against mosquitoes . in that study ,
area was a predictor variable for use of personal protective measures as found in the present study .
present study did not find much use of smoke and other traditional methods like insect repellent plants even in rural area .
they have been replaced by modern chemical methods for protection against mosquitoes probably due to their convenience .
ample knowledge and usage concerning traditional insect / mosquito repellent plants are other factors of interest .
application of smoke ( 91.5% ) was one of the most commonly known methods amongst local community by burning the plant parts such as leaves , stems , and roots as discussed by karunamoorthi et al . .
the most common perceived side effect was headache which was felt by 7.7% of the study subjects .
cough ( 3.2% ) , sore throat ( 2.7% ) , allergy ( 1.3% ) , and eye irritation ( 0.9% ) were other side effects reported . in another study carried out by sharma vp , it was found that 11.8% of people using various types of repellents complained of ill health effects .
breathing problems were the most common ( 4.2% ) , followed by eye irritation ( 2.8% ) , and often accompanied by bronchial irritation , headache , or skin reaction .
cough , cold , and running nose were accompanied with fever or sneezing in 1.6% cases .
similar findings were reported by another study conducted in pondicherry where perceived side effects of personal protective measure were allergy , breathing problems , cough , and headache .
there is a need to have a close watch for side effects of personal protective measures among users .
further research is also needed to develop safe and effective personal protective measures against mosquitoes .
 
 background . 
 mosquito - borne diseases constitute an important cause of morbidity and mortality . 
 the use of personal protective measures ( ppm ) like mats , bednets , screening , repellents , liquid vaporizers , mosquito coils , and so forth has been advocated as an effective tool in control of mosquito - borne diseases , but data about the safety profile of personal protective measures is still scarce . objective . to study the usage and side effects of personal protective measures against mosquitoes among current users in delhi . 
 materials and methods . a community - based cross - sectional study among 350 adult individuals selected by systematic sampling method . 
 data was collected using pretested semistructured questionnaire after taking written informed consent . 
 data was analysed using spss version 17 . 
 chi - square / fisher 's exact test was used for qualitative variables to find association and p value < 0.05 was considered significant . results . out of 350 families selected , 210 belonged to rural area and 140 to urban area . 
 personal protective measures were used by 219 ( 62.5% ) subjects . 
 liquid vaporizer was the most preferred method ( 41.4% ) . 
 most common perceived side effect of personal protective measures was headache ( 7.7% ) . 
 other perceived side effects were cough ( 3.2% ) , sore throat ( 2.7% ) , allergy ( 1.3% ) , and eye irritation ( 0.9% ) predominantly among coil users . 
 conclusion . 
 there is a need to have a close watch for side effects of personal protective measures among users . 
 further research is also needed to develop safe and effective personal protective measures against mosquitoes . 
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusion