Self-reported tick exposure as an indicator of Lyme disease risk in an endemic region of Quebec, Canada

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DOI

https://doi.org/10.1016/j.ttbdis.2023.102271

Language of the publication
English
Date
2024-01
Type
Article
Author(s)
  • Bowser, Natasha
  • Bouchard, Catherine
  • Sautié Castellanos, Miguel
  • Baron, Geneviève
  • Carabin, Hélène
  • Chuard, Pierre
  • Leighton, Patrick
  • Milord, François
  • Richard, Lucie
  • Savage, Jade
  • Tardy, Olivia
  • Aenishaenslin, Cécile
Publisher
Elsevier GmbH

Abstract

BACKGROUND: Lyme disease (LD) and other tick-borne diseases are emerging across Canada. Spatial and temporal LD risk is typically estimated using acarological surveillance and reported human cases, the former not considering human behavior leading to tick exposure and the latter occurring after infection. OBJECTIVES: The primary objective was to explore, at the census subdivision level (CSD), the associations of self-reported tick exposure, alternative risk indicators (predicted tick density, eTick submissions, public health risk level), and ecological variables (Ixodes scapularis habitat suitability index and cumulative degree days > 0 °C) with incidence proportion of LD. A secondary objective was to explore which of these predictor variables were associated with self-reported tick exposure at the CSD level. METHODS: Self-reported tick exposure was measured in a cross-sectional populational health survey conducted in 2018, among 10,790 respondents living in 116 CSDs of the Estrie region, Quebec, Canada. The number of reported LD cases per CSD in 2018 was obtained from the public health department. Generalized linear mixed-effets models accounting for spatial autocorrelation were built to fulfill the objectives. RESULTS: Self-reported tick exposure ranged from 0.0 % to 61.5 % (median 8.9 %) and reported LD incidence rates ranged from 0 to 324 cases per 100,000 person-years, per CSD. A positive association was found between self-reported tick exposure and LD incidence proportion (ß = 0.08, CI = 0.04,0.11, p < 0.0001). The best-fit model included public health risk level (AIC: 144.2), followed by predicted tick density, ecological variables, self-reported tick exposure and eTick submissions (AIC: 158.4, 158.4, 160.4 and 170.1 respectively). Predicted tick density was the only significant predictor of self-reported tick exposure (ß = 0.83, CI = 0.16,1.50, p = 0.02). DISCUSSION: This proof-of-concept study explores self-reported tick exposure as a potential indicator of LD risk using populational survey data. This approach may offer a low-cost and simple tool for evaluating LD risk and deserves further evaluation.

Plain language summary

Lyme disease (LD) and other tick-borne diseases are emerging across Canada. The primary objective of this research was to explore the associations of self-reported tick exposure, alternative risk indicators, and ecological variables with incidence proportion of LD. A secondary objective was to explore which of these predictor variables were associated with self-reported tick exposure at the census subdivision level (CSD) level. Self-reported tick exposure ranged from 0.0 % to 61.5 % (median 8.9 %) and reported LD incidence rates ranged from 0 to 324 cases per 100,000 person-years, per CSD. A positive association was found between self-reported tick exposure and LD incidence proportion. The best-fit model included public health risk level, followed by predicted tick density, ecological variables, self-reported tick exposure and eTick submissions. Predicted tick density was the only significant predictor of self-reported tick exposure. This proof-of-concept study explores self-reported tick exposure as a potential indicator of LD risk using populational survey data. This approach may offer a low-cost and simple tool for evaluating LD risk and deserves further evaluation.

Subject

  • Health

Keywords

  • Tick bite,
  • Tick exposure,
  • Tick encounter,
  • Tick-borne disease,
  • Lyme disease,
  • Surveillance

Rights

Pagination

1-12

Peer review

Yes

Open access level

Gold

Identifiers

PubMed ID
37866213
ISSN
1877-9603

Article

Journal title
Ticks and Tick-borne Diseases
Journal volume
15
Journal issue
1
Article number
102271

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Collection(s)

Communicable diseases

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