Evidence of rapid changes in Lyme disease awareness in Canada.

Lyme disease (LD) is emerging in Canada. A key preventive strategy is promoting the adoption by the general public of personal preventive behaviors regarding tick bites. The aim of this study was to measure the changes in public awareness toward ticks and LD before and after the launch of a national communication campaign in Canada using data from two surveys conducted in March and December 2014. The results show a significant increase in awareness of LD after compared to before the campaign, but also suggest that the importance of this increase is not equal amongst Canadian regions. Moreover, respondents whose level of awareness increased most significantly were those who lived in regions with low entomologic risk. The findings underline the importance of risk communications for emerging diseases and reinforce the need to understand the specific characteristics of the targeted populations before the implementation of communication campaigns to increase their efficacy.

Aenishaenslin C ，Bouchard C ，Koffi JK ，Pelcat Y ，Ogden NH ... -  《-》

Exposure and preventive behaviours toward ticks and Lyme disease in Canada: Results from a first national survey.

Lyme disease (LD) risk is increasing in Canada. In 2014, the government of Canada launched a national communication campaign to raise awareness and promote the adoption of individual preventive behaviours toward ticks and LD. The objectives of this study were to evaluate and compare the adoption of LD preventive behaviours and the exposure to tick bites of Canadians in the five main targeted regions (British Columbia, Prairie provinces, Ontario, Quebec and the Atlantic provinces). A national survey was conducted in December 2014 (n=2876) to collect data on LD awareness, behaviours and risk factors. Overall, the proportion of respondents reporting tick exposure was high (20%). The results suggest that even though LD awareness was found to be high (with only 12% of the respondents reporting that they never heard about LD), less than half of the Canadians who heard about it have adopted specific preventive behaviours toward tick bites, such as regular tick checks (reported by 52%), protective clothing (50%), using tick repellent (41%) or shower or bath (41%) after visiting a wooded area in a LD risk area. Moreover, significant differences were found between regions, gender, age groups and dog ownership status, regarding preventive behaviours and factors of exposure. A high level of knowledge of Lyme disease, living in the Prairie region, as well as having found a tick on oneself or a relative, were found to be associated with the adoption of preventive behaviours. This study underlines the importance to take into account specific regional characteristics of risk and to maintain public health communication efforts through time in order to increase the adoption of preventive behaviours of Canadians.

Aenishaenslin C ，Bouchard C ，Koffi JK ，Ogden NH ... -  《-》

Behavioral risk factors associated with reported tick exposure in a Lyme disease high incidence region in Canada.

Tick-borne diseases, and especially Lyme Disease (LD), are on the rise in Canada and have been met with increasing public health concern. To face these emerging threats, education on the prevention of tick bites remains the mainstay of public health intervention. The objective of this study was to assess the adoption of preventive behaviors toward tick bites and LD and to investigate the association between behavioral risk factors and reported tick exposure in a Canadian, LD high incidence region (Estrie region, Quebec, Canada). A cross-sectional study was conducted in 2018 which used a telephone questionnaire administered to a random sample of 10,790 adult residents of the study region. Questions investigated tick exposure, LD awareness, attitudes towards LD risk, outdoor and preventive behaviors, as well as antibiotic post-exposure prophylaxis (PEP) treatments in the case of a tick bite. Descriptive and multivariable analyses were carried out, considering the nine administrative subregions and the stratified survey design. The sub-regional prevalence of reported tick exposure in the previous year ranged from 3.4 to 21.9%. The proportion of respondents that adopted preventive behaviors varied from 27.0% (tick checks) to 30.1% (tick repellent) and 44.6% (shower after outdoor activities). A minority of respondents (15.9%) that sought healthcare after a tick bite received a PEP treatment. Performing tick checks (Odds ratio = 4.33), time spent outdoors (OR = 3.09) and living in a subregion with a higher public health LD risk level (OR = 2.14) were associated with reported tick exposure in multivariable models. This study highlights the low level of adoption of preventive behaviors against tick bites in a region where LD risk is amongst the highest in Canada. This suggests a concerning lack of improvement in LD prevention, as low levels of adoption were already reported in studies conducted in the last decade. Innovative and evidence-based approaches to improve education on ticks and tick-borne diseases and to promote behavior changes are urgently needed in Canada.

Aenishaenslin C ，Charland K ，Bowser N ，Perez-Trejo E ，Baron G ，Milord F ，Bouchard C ... -  《BMC PUBLIC HEALTH》

Factors associated with preventive behaviors regarding Lyme disease in Canada and Switzerland: a comparative study.

Aenishaenslin C ，Michel P ，Ravel A ，Gern L ，Milord F ，Waaub JP ，Bélanger D ... -  《BMC PUBLIC HEALTH》

Knowledge and preventive behaviors towards tick-borne diseases in Delaware.

Delaware is among the top 10 states in the United States with the highest incidence for Lyme disease. The Delaware Division of Public Health (DPH) therefore has been working diligently to prevent and control tick-borne diseases through a variety of interventions including awareness campaigns and educational programs. To assess if tick-borne disease related information is reaching Delawareans through these programs, DPH in collaboration with Delaware State University administered an anonymous survey to 1755 participants in all three of Delaware counties during May 2017. The questionnaire assessed individuals' general knowledge about tick-borne diseases and performance of selected tick-borne disease prevention methods Overall, participants' knowledge of tick-borne diseases was poor; only 38.4% of respondents stated that ticks were problematic in Delaware and only 12.7% of respondents "strongly agreed" that Lyme disease is a problem in Delaware. A little over half of the respondents (51.6%) indicated having seen advertisements/infomercials/flyers for protection from ticks or the disease agents spread by ticks; the most common places for viewing these advertisements were doctor's offices and through social media. The reported frequency of performing preventive behaviors was variable and disparities were observed by age, race, gender and county of residence. Existing public health communication efforts on tick-borne diseases in Delaware do not appear to be having the desired effect. This study provides important baseline information to rethink communication channels for education and more effectively guide future tick-borne disease awareness campaigns.

Gupta S ，Eggers P ，Arana A ，Kresse B ，Rios K ，Brown L ，Sampson L ，Kploanyi M ... -  《-》