Systematic review and meta-analysis of tick-borne disease risk factors in residential yards, neighborhoods, and beyond.

Autor: Fischhoff IR; Cary Institute of Ecosystem Studies, 2801 Sharon Turnpike, Millbrook, NY, 12545, USA. fischhoff@gmail.com., Bowden SE; Cary Institute of Ecosystem Studies, 2801 Sharon Turnpike, Millbrook, NY, 12545, USA.; Eagle Medical Services, LLC, 2835 Brandywine Rd. Suite 200, Atlanta, GA, 30341, USA.; Division of Global Migration and Quarantine, Centers for Disease Control, 1600 Clifton Road, Atlanta, GA, 30329-4027, USA., Keesing F; Bard College, PO Box 5000, Annandale-on-Hudson, New York, 12504, USA., Ostfeld RS; Cary Institute of Ecosystem Studies, 2801 Sharon Turnpike, Millbrook, NY, 12545, USA.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2019 Oct 17; Vol. 19 (1), pp. 861. Date of Electronic Publication: 2019 Oct 17.
DOI: 10.1186/s12879-019-4484-3
Abstrakt: Background: Exposure to blacklegged ticks Ixodes scapularis that transmit pathogens is thought to occur peri-domestically. However, the locations where people most frequently encounter infected ticks are not well characterized, leading to mixed messages from public health officials about where risk is highest.
Methods: We conducted a systematic review and meta-analysis on spatial risk factors for tick-borne disease and tick bites in eastern North America. We examined three scales: the residential yard, the neighborhood surrounding (but not including) the yard, and outside the neighborhood. Nineteen eligible studies represented 2741 cases of tick-borne illness and 1447 tick bites. Using random effects models, we derived pooled odds ratio (OR) estimates.
Results: The meta-analysis revealed significant disease risk factors at the scale of the yard (OR 2.60 95% CI 1.96 - 3.46), the neighborhood (OR 4.08 95% CI 2.49 - 6.68), and outside the neighborhood (OR 2.03 95% CI 1.59 - 2.59). Although significant risk exists at each scale, neighborhood scale risk factors best explained disease exposure. Analysis of variance revealed risk at the neighborhood scale was 57% greater than risk at the yard scale and 101% greater than risk outside the neighborhood.
Conclusions: This analysis emphasizes the importance of understanding and reducing tick-borne disease risk at the neighborhood scale. Risk-reducing interventions applied at each scale could be effective, but interventions applied at the neighborhood scale are most likely to protect human health.
Trial Registration: The study was registered with PROSPERO: CRD42017079169 .
Databáze: MEDLINE
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