Abstract
BackgroundLyme borreliosis (LB) is the most common tick-borne disease in the United States and Europe. The incidence is 13.4 per 100,000 inhabitants in the United States and more than 300 per 100,000 inhabitants in Europe. Children are at highest risk of LB. In the Netherlands in 2007, the incidence of tick bites in children between 10–14 years varied from 7,000 -11,000 per 100,000, depending on age. This study among Dutch school children aimed to examine the knowledge, perceived threat, and perceived importance of protective behaviour in relation to tick bites and their potential consequences.MethodsIn April 2012, the municipal health services (MHS) contacted primary schools to recruit children 9–13 years by telephone, e-mail, or advertisement in MHS newsletters. In total, 1,447 children from 40 schools participated in this study by completing a specifically developed and pretested compact paper questionnaire. Regression models were used to determine which covariates (e.g. forest cover, previous education, knowledge) are associated with our response variables.Results70% (n = 1,015) of the children answered at least six out of seven knowledge questions correctly. The vast majority (93%; n = 1345) regarded body checks as very or somewhat important, 18% (n = 260) was routinely checked by their parents. More frequent body checks were associated with good knowledge about ticks and tick-borne diseases and knowing persons who got ill after tick bite. Children in areas with a higher forest cover were more likely to be checked frequently.ConclusionsMost children have a good knowledge of ticks and the potential consequences of tick bites. Knowing persons who personally got ill after tick-bite is associated with a good knowledge score and leads to higher susceptibility and better appreciation of the need for body checks. Perceived severity is associated with a good knowledge score and with knowing persons who got ill after tick-bite. Is seems to be useful to additionally address children in health education regarding ticks and tick-borne diseases. The relationship between health education programs for children (and their parents) about ticks and their possible consequences and prevention of these deserves further study.
Highlights
Lyme borreliosis (LB) is the most common tick-borne disease in the United States and Europe
In Europe, where the main endemic areas are located in Scandinavia and the south central areas of Germany, Austria, north-east Italy, and Slovenia, the reported incidence is more than 300 cases per 100,000 inhabitants
For this construct we considered a generalised linear mixed models (GLMM) with multinomial distribution, but found that it led to convergence problems, presumably due to model complexity
Summary
Lyme borreliosis (LB) is the most common tick-borne disease in the United States and Europe. In the Netherlands in 2007, the incidence of tick bites in children between 10–14 years varied from 7,000 -11,000 per 100,000, depending on age. Lyme borreliosis (LB) is the most common tick-borne disease in the United States (USA) and Europe. In 1994, patients visiting the GP for erythema migrans (EM), a circular red skin rash around the place of the tick bite, was estimated at 39 per 100,000 inhabitants. This rate increased to 134 per 100,000 in 2009 [2], and similar rises occurred in other European countries as well [3]
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