Risk Factors Associated with Bedbug (Cimex spp.) Infestations Among Hong Kong Households: A Cross-Sectional Study

Abstract

To investigate the risk factors associated with bedbug infestations among Hong Kong households, self-reported questionnaires in Chinese were distributed online between June 2019 to July 2020. The questionnaire collected data on participants’ sociodemographics, history of bedbug infestation, and housing situation. Among the 663 participants who completed the questionnaire, 422 (63.7%) have experienced bedbug infestations in the past year, they were concentrated around the Kowloon region. Weighted bivariate and multivariate binary logistic regression were performed to identify the statistically significant (p-value <0.05) factors associated with bedbug infestations. Bivariate analysis shows a positive correlation between the number of reported dilapidated housing features and bedbug infestation. For multivariate analysis, those aged 45-64 (OR=2.53, 95% CI 1.30-4.91), have primary education or below (OR=9.43, 95% CI 3.12-28.44), and monthly household income ≤HKD30,000 (OR=1.69, 95% CI 1.15-2.5) were more likely to have bedbug infestation compared to their respective reference groups, i.e., ≥65, tertiary education, and >HKD30,000; housing risk factors identified are living in subdivided flats (OR=16.53, 95% CI 1.01-269.72), crowded household (OR=1.55, 95% CI 1.06-2.28), having second-hand furniture (OR=2.97, 95% CI 1.16-7.58), housing cleanliness issues (OR=2.66, 95% CI 1.13-6.25), and presence of bedbugs in neighbouring residential units (OR=3.32, 95% CI 1.57-7.04) or on the streets (OR=1.9, 95% CI 1.12-3.23). This study has identified lower income, lower education level, crowded household, living in subdivided flats, and certain dilapidated housing features to be risk factors of bedbug infestations; efforts and policies should prioritise vulnerable groups and focus on addressing the housing risk factors identified in this study.