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

被引:40
作者
Fischhoff, Ilya R. [1 ]
Bowden, Sarah E. [1 ,2 ,3 ]
Keesing, Felicia [4 ]
Ostfeld, Richard S. [1 ]
机构
[1] Cary Inst Ecosyst Studies, 2801 Sharon Turnpike, Millbrook, NY 12545 USA
[2] Eagle Med Serv LLC, 2835 Brandywine Rd,Suite 200, Atlanta, GA 30341 USA
[3] Ctr Dis Control, Div Global Migrat & Quarantine, 1600 Clifton Rd, Atlanta, GA 30329 USA
[4] Bard Coll, POB 5000, Annandale on Hudson, NY 12504 USA
关键词
Peri-domestic; Ixodes scapularis; Lyme disease; Babesiosis; Anaplasmosis; Tick bites; Spatial scale; LYME-DISEASE; UNITED-STATES; LANDSCAPE; EXPOSURE; COUNTY; SURVEILLANCE; ENVIRONMENT; PREVENTION; BABESIOSIS; BEHAVIORS;
D O I
10.1186/s12879-019-4484-3
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
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.
引用
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页数:11
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