The Impact of Bedbug (Cimex spp.) Bites on Self-Rated Health and Average Hours of Sleep per Day: A Cross-Sectional Study among Hong Kong Bedbug Victims
by
, , , and
Eddy Hin Chung Fung
1,2,*, 
Siu Wai Chiu
3,4,
Hon-Ming Lam
3
,
Roger Yat-Nork Chung
1,5, 
Samuel Yeung Shan Wong
1,5,
Siu Ming Chan
6,
Dong Dong
1 and
Hung Wong
5,7 1
JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
2
Faculty of Law, The Chinese University of Hong Kong, Hong Kong, China
3
School of Life Science, The Chinese University of Hong Kong, Hong Kong, China
4
Hong Kong Poison Information Centre, Hospital Authority, Hong Kong, China
5
CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
6
Department of Social and Behavioural Sciences (Social Work), City University of Hong Kong, Hong Kong, China
7
Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
*
Author to whom correspondence should be addressed.
Insects 2021, 12(11), 1027; https://doi.org/10.3390/insects12111027
Submission received: 18 October 2021
/
Revised: 2 November 2021
/
Accepted: 11 November 2021
/
Published: 14 November 2021
(This article belongs to the Section Insect Pest and Vector Management)
Simple Summary
Bedbugs (Cimex spp.) are a nuisance pest of significant public health importance that is on the rise globally, especially in crowded cities such as Hong Kong. Bedbug infestations disproportionately affect underprivileged communities living in crowded and dilapidated housing. This study uses an online survey to investigate the health impacts of bedbug infestations among bedbug victims. This study found that most bedbug victims experienced ≥five bites in the past month, usually on the arms and legs. The most common reaction to bites were itchiness, redness, and swelling of the skin, and difficulties sleeping or restlessness. Bites usually occurred during sleep, impacting the bedbug victim’s mental and emotional health, and sleeping quality most severely. The adverse health outcomes of bedbug infestations were associated with the lower self-rated health and average hours of sleep per day of bedbug victims. This study brings attention to the neglected issue of bedbug infestations by providing evidence on the scope of its health impacts, informing public health interventions including public education and extermination programmes, and supportive laws and policies for adequate housing and hygiene. The successful control of bedbugs in an international city such as Hong Kong can inform the control of the global bedbug resurgence.
Abstract
Bedbugs (Cimex spp.) are a nuisance public-health pest that is on the rise globally, particularly in crowded cities such as Hong Kong. To investigate the health impacts of bedbug infestations among bedbug victims, online surveys were distributed in Hong Kong between June 2019 to July 2020. Data on sociodemographics, self-rated health, average hours of sleep per day, and details of bedbug infestation were collected. Bivariate and multivariable analysis were performed using logistic regression. The survey identified 422 bedbug victims; among them, 223 (52.9%) experienced ≥five bites in the past month; most bites occurred on the arms (n = 202, 47.8%) and legs (n = 215, 51%), and the most common reaction to bites were itchiness (n = 322, 76.3%), redness, and swelling of the skin (n = 246, 58.1%), and difficulties sleeping or restlessness (n = 125, 29.6%). Bites usually occurred during sleep (n = 230, 54.5%). For impact on daily life in the past month, most bedbug victims reported moderate to severe impact on mental and emotional health (n = 223, 52.8%) and sleeping quality (n = 239, 56.6%). Lower self-rated health (aOR < 1) was independently associated with impact on physical appearance (p = 0.008), spending money on medication or doctor consultation (p = 0.04), number of bites in the past month (p = 0.023), and irregular time of bites (p = 0.003). Lower average hours of sleep per day (aOR < 1) was independently associated with impact on mental and emotional health (p = 0.016). This study brings attention to the neglected issue of bedbug infestation by considering bedbugs as an infectious agent instead of a vector and providing empirical evidence describing its health impacts.
Keywords:
bed bugs; Cimex spp.; Hong Kong; sleep disturbance; health impact; public health; causal agent; infectious agent; vector
