Controlling Haematophagous Insects: The Quality-of-Life Scenario - Urban Insect Pests: Sustainable Management Strategies - page 185

Poor structures organization with neighborhood support, if

the measures are to be effective' (Skovmand
et al. , 2011). For example, treating cesspools
with the biolarvicide Bacillus sphaericus ,
improving water pumping stations to
prevent the accumulation of stagnant water,
levelling roads and engineering concrete
gutters to drain runoff water, installing
rubbish containers as alternatives to drain-
age channels for waste disposal, and
improving septic tanks to facilitate fl ushing
successfully reduced breeding sites and
nuisance populations of Culex quinque-
fasciatus and Anopheles gambiae in
Burkina Faso (Skovmand et al. , 2011).
Neighbourhood support was essential to
improve the health of children in a slum in
Chennai, India (Balasubramaniam et al. ,
2012). An approach that integrated direct,
primary health care with self-help groups
from the slums resulted in 88% usage of
safe rubbish disposal that reduced breeding
sites for mosquitoes and rodents, 95% of
households with latrines, and not a single
case of vector-borne disease in 1 year
(Balasubramaniam et al. , 2012). A trial in
Sri Lanka that involved the community to
build partnerships with local stakeholders,
practise waste management at the household
level, compost biodegradable household
waste, educate residents on the public
health impact of waste management and
improve rubbish collection by the local
government authorities led to a decrease in
A. aegypti pupae populations (Abeyewick-
reme et al. , 2012).

Older, urban housing typically presents
multiple hazards to resident health, includ-
ing moisture and mould, lead-based paint
and pest problems, including rodents, cock-
roaches and bed bugs. When paint stabil-
ization, lead dust remediation and
integrated pest management (IPM) were
instituted in New York City residences,
signifi cant reductions were seen in the
number of infestations of cockroaches and
rodents, as well as other health hazards,
such as lead dust and mould (Klitzman et
al. , 2005). The greatest reduction in
cockroach antigen levels was detected in
residences with the highest baseline levels
and where residents attended training
sessions (Klitzman et al. , 2005). When out-
reach workers trained residents in the use of
a deep vacuum cleaner, apartments con-
taminated with lead, pesticides, poisonous
metals and cockroach or mite allergens
reduced dust exposure by 90% and en-
couraged cleaner, less cluttered apartments
(Roberts et al. , 2009).
The use of IPM programmes with the
obvious benefi t of reducing pest populations
can also reduce indoor pesticide residues,
which have been linked to cancer and
respiratory disease. Pyrethroids and organo-
phosphates have commonly been detected
in urban, lower-income, multi-unit dwel-
lings (Lu et al. , 2013). Residues of
permethrin, chlorpyrifos, diazinon, cyper-
methrin and cyfl uthrin were found in public
housing in Boston, Massachusetts (Julien et
al. , 2008). An IPM programme was instituted
in New York City to reduce cockroach
infestations and indoor pyrethroid exposure
among pregnant women in a lower-income
neighbourhood (Williams et al. , 2006).
Strategies included professional cleaning,
sealing of pest entry points, application of
low-toxicity pesticides and education. Cock-
roach infestations signifi cantly decreased
and insecticide levels in maternal blood
were signifi cantly lower from women in the
experimental series than those in the con-
trols (Williams et al. , 2006).
Management of rubbish and wastewater
in cities is feasible but requires 'a municipal

Financial Impact of Haematophagous
Non-vectors

Unlike mosquitoes, bed bugs do not transmit
pathogens and no one has ever died of bed
bug bites. Chronic bed bug infestations can
be devastating, however, especially in
lower-income, multi-unit housing. The
common bed bug, Cimex lectularius , and
the tropical bed bug, Cimex hemipterus , are
examples of haematophagous insects that
are not vectors but still have an enormous
public health, economic and psychological
impact. Reducing the risk of bed bug