First tick and tick damage perception survey among sedentary and transhumant pastoralists in Burkina Faso and Benin.

BACKGROUND: Transhumance, a main ancestral animal production strategy of the West African Countries (WAC), can favour the spread of vectors and vector-borne diseases within and/or across countries. Transhumance has been implicated in such spread as well as that of related tick-borne diseases (TBD). METHODS AND PRINCIPAL FINDINGS: Using a questionnaire survey and statistical modelling, this study explores the perception of herders about ticks and TBD in cattle, their practices in tick control and the social groups involved in cattle farming in eastern Burkina Faso (46 random herds) and in the northern Benin (44 random herds). Results show that most of the herders (79%) are from the Fulani social group. The principal and secondary activities of herders are respectively cattle farming and agriculture. The mean age of pastoralists is between 40 and 50 years depending on the province of origin and 60% of the surveyed herds practice internal or transboundary transhumance. Herders have a clear knowledge of different genus of ticks except the genus Rhipicephalus. Their knowledge of TBD is very limited. These results also reveal that herders in Benin use less acaricides treatment calendar compared with those in Burkina Faso. Transhumant pastoralists (i.e. transhumant cattle farmers) plan more acaricide treatment and have more cows with lost teats (i.e. tick damage) than the sedentary ones. In addition, amitraz appears to be the main acaricide compound used by herders for tick control (68%) but its use is inappropriate and its source is frequently the unregulated market. CONCLUSIONS AND SIGNIFICANCE: All of these findings can induce acaricide resistance especially as the inefficacy of amitraz against Rhipicephalus (Boophilus) microplus has already been reported in previous studies. Such results would help to elaborate suitable strategies of control and prevention of ticks and TBD in Burkina Faso and Benin.

Do tick-borne diseases affect outdoor teaching in Slovenian preschools?

Childhood experiences with nature are decisive for children's wellbeing. The need for outdoor activities has been duly recognized in the preschool curriculum in Slovenia. However, there are some obstacles to this approach-specifically, tick-borne diseases. This study examines the views and experiences of Slovenian preschool teachers (n = 158) with ticks and tick-borne diseases in order to create a safer environment for the further development of outdoor education. The majority of the respondents engage in outdoor teaching once or several times a week. They have very frequent contact with ticks and tick-borne diseases in their professional lives. More than four-fifths of the respondents carry out some tick-prevention measures in preschools, but room for improvement remains. The respondents report rare cases in which parents or guardians have tried to prohibit them from visiting outdoor areas because of tick-borne diseases, and they explain how they dealt with the situation. The attitude of preschool teachers toward ticks and tick-borne diseases did not correlate significantly with the frequency with which they went outdoors in preschools. This study therefore concludes that, despite the objective risks associated with tick-borne diseases, there is still broad consensus among educators and parents on the importance of outdoor education in the early years.

Communal cattle farmer's knowledge, attitudes and practices on ticks (Acari: Ixodidae), tick control and acaricide resistance.

The aim of this study was to reveal communal farmer's knowledge, attitudes and practice on ticks and tick-borne diseases affecting cattle, tick control methods used and their knowledge on acaricide resistance. A total of 160 structured questionnaires are prepared and randomly administered to cattle farmers in Sinqu and Elundini communities in the Eastern Cape Province, South Africa. Associations between the area, gender, age, employment, source of income, level of education and farming experience were statistically tested using Chi-square test. Gall sickness (63%) was the most prevailing tick-borne disease in cattle during the summer season (61%). About 59% of the farmers had no knowledge of the effect of tick-borne diseases on cattle production, and 78% of respondents reported that ticks are the major challenge to cattle farming. Pour-on (61%) was the most commonly used acaricidal treatment system with every fortnight (40%) treatment frequency during the summer season and (31%) during the winter season. Pyrethroids (73%) were the most used acaricide compounds to control ticks, and about 65% of respondents perceived to have no knowledge of the use of ethnoveterinary medicines used to control ticks. Inefficacy of acaricide (44%) and undipped animals (42%) were regarded as the major contributing factors to the increased tick population and acaricide resistance. About 85% of respondents perceived that they do not practice acaricide rotation and 88% of the respondents had no knowledge of the acaricide resistance. Within the context of this study, ticks and tick-associated diseases are perceived by these farmers as the most important disease problem their cattle face. Thus, knowledge regarding the epidemiology of ticks and tick-borne diseases is key to control strategies, and farmer training should be encouraged to achieve better control of ticks and the diseases they transmit.

Knowledge, habits and attitudes towards TBE and other tick-borne diseases in German forestry trainees.

Tick-borne encephalitis (TBE) is an occupational hazard for forestry workers. We measured knowledge levels, misbeliefs, and vaccination rates in forestry trainees in order to tailor specific measures aimed at reducing occupational TBE incidence. A paper-based survey was performed at a central training site for forestry workers in the state of Baden-Wuerttemberg. The questionnaire contained items regarding vaccination status against tick-borne encephalitis virus (TBEV), self-reported tick-borne diseases, knowledge of and attitudes towards tick-borne disease, and practices in the context of ticks and tick bites. All trainees in the period June-December 2018 were surveyed. Statistical analyses were conducted using Mann-Whitney-Rank sum test and one-way ANOVA tests. Two-hundred-twenty-five trainees participated in the survey. Almost all (>99%) were aware of living in a TBE high-risk area. Eighty-three percent of respondents were vaccinated in line with current recommendations. Seventeen percent had no effective vaccination status. Twenty-seven percent believed that ticks can transmit only TBEV and Borrelia spp. Sixty-two percent knew that TBEV infections can be fatal. Only 8% of respondents use tick repellents and only 17% wear long sleeves and pants. Trainees who graduated from a six and (eight or) nine secondary school (Realschule and Abitur respectively) had more knowledge on ticks and tick-borne disease compared to graduates from a five year school (Hauptschule) (p = 0.002 and p = 0,037 respectively). Overall, the TBE vaccination rate is not high enough in this high-risk occupational group. We identified gaps in knowledge and practices that could have an impact on TBE incidence in this group if addressed. Further epidemiological research is needed on knowledge, attitudes, and practices in different high-risk populations.

Who is afraid of ticks and tick-borne diseases? Results from a cross-sectional survey in Scandinavia.

BACKGROUND: In Scandinavia, the distribution of ticks is expanding and tick-borne diseases constitute growing health risks. While the probability of getting a tick-borne disease after a tick bite is low, the health impacts can be large. This, as well as other characteristics of these diseases make tick-related risks difficult for laypeople to assess and perceived risk may differ substantially from actual risk. Understanding risk perceptions is important since it is the perceived risk, rather than actual risk, that determine behaviour and even more so for new and emerging risks. The aim of this study is to investigate knowledge and risk perceptions related to tick bites and the tick-borne diseases Lyme borreliosis (LB) and tick-borne encephalitis (TBE). By analysing risk perceptions and knowledge, the study helps inform the development of public health strategies in response to the increasing incidence of these diseases in Scandinavia. METHODS: Two thousand, six hundred sixty-eight respondents in Denmark, Norway and Sweden answered an online questionnaire with 48 questions, including 7 questions on risk perceptions and 9 knowledge questions. Chi-squared tests were used to analyse statistical differences between country sub-samples, gender and age groups. A multivariate regression model was used to analyse factors associated with risk perceptions. RESULTS: Risk perceptions were on average high in comparison with scientific estimates, with respondents grossly overrating the probability of contracting LB or TBE if bitten by a tick. Also, the average perceived seriousness of a single tick bite and of getting LB or TBE was high. Knowledge on the other hand was low, especially among men and the youngest age group (18-29 years). Higher levels of knowledge about tick-borne diseases were associated with lower perceived seriousness of tick bites and LB and higher perceived seriousness of TBE. Also, having been diagnosed with LB was negatively associated with the perceived seriousness of LB. CONCLUSIONS: Our results indicate that informing about ticks and tick-borne diseases would be a relevant public health strategy as it could make risk perceptions better aligned with actual risk. Should the TBE virus spread further in Denmark and Norway, increasing knowledge about TBE vaccination would be especially important.

Knowledge, attitudes, and behaviors regarding tick-borne disease prevention in endemic areas.

As part of a TickNET collaboration we evaluated the knowledge, attitudes, and behaviors related to tick-borne disease (TBD) prevention among persons living in endemic areas of Connecticut (CT) and Maryland (MD). Up-to-date information on the use of various prevention methods, as well as attitudes toward available and potential prevention options, is critical for effective promotion of recommended behaviors. During 2016-2017, printed invitations were mailed via the post office to 27,029 households requesting participation in an online survey regarding knowledge of TBD, risk perceptions, and prevention behaviors. Prevention behaviors included tick checks, showering/bathing, insect repellents, pet tick control, and chemical or natural pesticide use on residential properties. Associations of sociodemographic characteristics and knowledge and attitude variables with prevention behaviors were assessed in unadjusted analyses and multivariable models to calculate adjusted odds ratios (aOR). Participants were also asked if they would be willing to get a Lyme disease (LD) vaccine, if one becomes available. Overall, 1883 (7%) persons completed the survey. Participants reported using preventive behaviors most of the time or always as follows: pet tick control (83%), tick checks (58%), showering/bathing (42%), insect repellent (31%), and chemical (23%) or natural (15%) pesticides on property. Self-rated knowledge of LD, perceived prevalence of LD, perceived severity of LD, and perceived likelihood of contracting LD or another TBD were significantly (p < 0.05) associated with performing a tick check [aOR 2.5, aOR 1.71, aOR 1.36, aOR 1.83, respectively]. Female gender and perceived prevalence of LD were significantly associated with applying insect repellent [aOR 1.56, aOR 1.64, respectively]. Perceived prevalence of LD was significantly associated with showering or bathing, insect repellents, and pet tick control [aOR 1.42, aOR 1.64, aOR 1.92, respectively]. Income > $100,000 was significantly associated with applying a chemical or natural pesticide to one's property [aOR 1.29, aOR 1.40, respectively]. A majority of respondents (84%) reported that they were very likely or somewhat likely to get a LD vaccine if one were available. Few behaviors (tick checks and pet tick control) were reported to be practiced by more than half of the respondents living in LD endemic areas. Perceived prevalence of LD was the only factor associated with performing most of the prevention behaviors (tick checks, showering/bathing, use of insect repellents, and pet tick control). Use of chemical or natural pesticides appears to be driven by income. Greater efforts are needed to encourage use of prevention behaviors in endemic areas, and this may be facilitated by increasing awareness of local prevalence.

A qualitative study to explore farmworkers' knowledge, beliefs and preventive practices toward ticks and tick-borne diseases.

INTRODUCTION: Farmworkers are considered a high-risk group for tick-borne diseases (TBDs). This qualitative study aimed to gain an in-depth understanding of the farmworkers' experience, knowledge, health beliefs, information needs, and preventive practices of tick bites and TBDs. METHODOLOGY: A total of nine focus group discussions with 56 farmworkers across eight animal farms in Peninsular Malaysia were conducted between August and October 2013. RESULTS: Farmworkers explained their experience of tick bites, but no one reported TBDs. Many farmworkers indicated that they did not seek any medical treatment. There was a misconception that ticks are solely pathogenic to farm animals. Farmworkers perceived low severity and susceptibility of tick bites, and low self-efficacy of tick bite prevention, however, a group also perceived susceptibility to getting tick bites due to the characteristics of their job. Barriers for prevention were related to the perception and knowledge towards ticks. Farmworkers requested information about TBDs. CONCLUSIONS: This study of farmworkers identified gaps in the knowledge of TBDs, barriers of the tick bite preventive measures and information needs. These findings suggest a need for education programs to improve the knowledge of ticks and TBDs, change health beliefs and address the barriers of tick bite preventive measures.

Progress, challenges, and the role of public engagement to improve tick-borne disease literacy.

Vector-borne diseases have increased worldwide, facilitated by globalization and variations in climate. Tick and tick-borne disease researchers, veterinarians, medical practitioners, and public health specialists are working to share their expertise on tick ecology, disease transmission, diagnostics, and treatment in order to control tick-borne epidemics and potential pandemics. This review will be a brief overview of the current status of tick-borne diseases, challenges on the scientific and public fronts, and the role of public engagement in improving citizen education within the context of ticks and tick-borne disease research.

Spotted fever group Rickettsiae in Ticks from Missouri.

Tick-borne rickettsioses pose a major health threat among vector-borne infections in Missouri but there are some uncertainties regarding the vector competence and range of tick species, as well as the virulence of certain bacterial species. A survey was developed and implemented to assess local healthcare practitioners' awareness of the prevalence and diagnosis of tick-borne diseases. In addition, ticks collected from rural areas of St. Louis County, Missouri, were evaluated to detect spotted fever group (SFG) rickettsiae and to determine the most common tick species present. Physician responses showed a good general awareness of tick-borne diseases and antibiotic choices but responses varied regarding length of treatment, the most common tick-borne diseases, and tick vectors. No new tick vectors were collected in the area; Rickettsia amblyommatis was the predominant SFG species, and it was detected in Amblyomma americanum, Dermacentor variabilis, andIxodes scapularis; Rickettsia montanensis was detected in D. variabilis. The high prevalence of Rickettsia amblyommatis in these ticks suggests that there is a high risk of exposure to this SFG rickettsial species to humans and that it may be providing some cross-protective immunity to R. rickettsii.

Learning to live with ticks? The role of exposure and risk perceptions in protective behaviour against tick-borne diseases.

The purpose of this study is to analyse the role of risk perceptions and exposure for protective behaviour against tick bites and the related diseases Lyme borreliosis (LB) and tick-borne encephalitis (TBE), both of which are growing health concerns. We use data from a national survey in Sweden with respondents in geographical areas with substantial differences in both abundance of ticks and incidence of LB and TBE. We find that the share of respondents who frequently use protective clothing (64%), perform tick checks (63%) or avoid tall grass while in areas with ticks (48%) is relatively high. However, the use of protective measures is uneven and a considerably lower share tuck their trousers into their socks (18%), use repellent against ticks (16%) or use a combination of protective measures. Thirty-one per cent of the respondents report one or more tick bites in the last year and 68% report one or more lifetime tick bites, indicating that it is difficult to protect oneself from tick bites. There is a strong positive association between exposure and checking the skin for ticks, but exposure is only weakly associated with other protective measures. Tick bites are perceived as a serious health risk by as many as 43% of the respondents. The perception that a single tick bite is serious is negatively associated with actual exposure to ticks, while the opposite is true for the perception that tick bites constitute a serious lifetime health risk. This indicates a learning effect in relation to risk perceptions and the performance of tick checks, but not in relation to other protective measures. Recommendations include informing people of the risks associated with tick bites, the efficacy of various protective measures and the importance of combining multiple types of protection. Given the high exposure to tick bites, the growing incidence of TBE and LB, and the difficulties in preventing tick bites, other preventive measures should be further discussed, including vaccination programmes.

Knowledge, attitudes, and practices regarding ticks and tick-borne diseases, Finland.

Tick-borne encephalitis (TBE) and Lyme borreliosis (LB) are endemic in Finland, with tens and thousands of cases, respectively, reported annually. We performed a field survey to investigate people's knowledge, attitudes and practices (KAP) regarding ticks, tick-borne diseases, and prevention strategies. The KAP were assessed using a pre-validated anonymous questionnaire consisting of 39 questions and statements. On two consecutive days in July 2016, convenience sampling was used in the cities of Parainen and Kotka, located in high-risk areas of tick-borne diseases, particularly of TBE. In attitudes and practices sections, each question was scored and analysed with ordered logistic regression model. In total, 101 individuals responded. The TBE vaccination rate among respondents was 40%. The best known preventive measures were having vaccination against TBE (88%), and wearing long sleeves and pants against ticks (81%). Two-thirds incorrectly identified the ring-like rash as a symptom of TBE. Of all respondents, 78% could not exclude that TBE can be treated with antibiotics; 55% that vaccine protects against LB; and 46% that it protects against ticks. The minority (14%) believed tick repellents to be effective. Among preventive behaviour, the quick removal of an attached tick was most frequently applied (97%). Repellents were used by 21% when visiting tick-infested areas. Significant associations were found between the vaccination status and having a correct belief that the vaccine protects against TBE (P<0.001) but not against ticks (P<0.05), or LB (P<0.001). KAP is a quick and easy tool to get a rough estimation on people's awareness regarding ticks and tick-borne diseases. We identified gaps in knowledge and misbeliefs. Our results can be used in public health communication tools on tick-borne diseases, especially those on intervention strategies.

Students' attitudes to tick risks.

INTRODUCTION AND OBJECTIVES: The ever-increasing number of patients with tick-borne diseases resulted in the presented study investigating the awareness, attitudes and knowledge among students about the threats arising from tick bites and preventive anti-tick practices. MATERIALS AND METHOD: Questionnaires concerning these issues were distributed amongst Czech and Polish university students of science. Responses were analyzed by nationality and by gender. RESULTS: Nearly all respondents were aware of the risks arising from ticks and could name at least one disease transmitted by ticks. The Czech students felt more threatened by tick-borne diseases, had more frequently suffered from Lyme borreliosis and were vaccinated against tick-borne encephalitis more often than the Polish students. A large number of the participants applied preventive measures against ticks in order to protect themselves. The Czech students believed in the effectiveness of repellents statistically more often than the Polish students, while effectiveness is the main criterion for selection of the right repellent in both groups. CONCLUSION: Differences in preferences between the two nations appeared in many areas, e.g. the Czechs felt more threatened by all kind of risks and suffered from Lyme disease more frequently. Gaps can still be found in both the knowledge and behaviour among the respondents. It can be expected that the general public knowledge of this issue is rather limited in comparison with the students participating in the study, who are systematically educated in the field.