Knowledge, Attitudes, and Behaviors Regarding Lyme Borreliosis Prevention in the Endemic Area of Northeastern Poland

Abstract

(1) Background: The incidence of Lyme borreliosis (LB) is increasing in Europe. The new LB vaccine is still in clinical development, thus the dissemination of knowledge about the disease is essential. We assessed the knowledge, attitudes and preventive practices (KAP) against tick-borne diseases (TBDs) of people living in the endemic area in northeastern Poland. (2) Methods: We surveyed 406 adults using a 37-item anonymous paper survey. The data were analyzed with regression models. (3) Results: The two most popular knowledge sources were the Internet and doctors, selected by 77.8% and 53.4%, respectively. Respondents felt moderately knowledgeable about TBDs and tick bite prophylaxis (median scores 5/10, and 6/10, respectively), considered TBDs to be a significant health threat (median 8/10), attributed high risk to tick mouthparts remaining in the skin after tick removal (median 10/10), and shared multiple misconceptions regarding LB transmission, symptoms, and management. General knowledge scores (GKS) about TBDs and tick protection practices scores (TPS) were moderate (65.0%; IQR, 55.8–71.7%, 63.6%; 54.5–72.7%, respectively). Only 48.0% had a positive attitude towards TBE vaccination. A recent tick-bite was associated with higher GKS (OR, 2.55; 95% CI, 1.27–5.10; p = 0.008), higher TPS (OR 4.76, 95% CI, 2.0–11.1; p < 0.001), and a positive attitude towards TBE vaccine (OR 2.10, 1.07–4.10, p = 0.030). A positive vaccine attitude was also associated with obtaining TBD knowledge from doctors and other verified sources (OR, 2.654, 1.66–4.23; p < 0.001). Age, place of residence, and frequent exposure to ticks in green areas were not associated with GKS, TPS, nor vaccine attitude. (4) Conclusions: Increased risk perceptions are associated with adoption of behaviors preventing TBDs. Medical professionals play an important role in communicating knowledge about TBDs. There is a need to revise current communication strategies with respect to tick bites and prevention of LB and other TBDs.

Knowledge, protection behaviours and seroprevalence of Lyme borreliosis in inhabitants of Lublin Province , eastern Poland – evaluation of a prophylaxis programme

“…These findings are in accordance with other studies confirming that women, persons with a high education level and better knowledge and awareness about TBD, were more likely able to prevent tick bites [15,16]. Numerous studies have confirmed that increased risk perceptions positively affect the use of prevention measures [16]. The current study only partially confirmed that high awareness and personal experience influence tick protection behaviours.…”

“…The use of protective measures was higher among respondents with diagnosed or suspected Lyme borreliosis before participation in the prophylaxis programme. These findings are in accordance with other studies confirming that women, persons with a high education level and better knowledge and awareness about TBD, were more likely able to prevent tick bites [15,16]. Numerous studies have confirmed that increased risk perceptions positively affect the use of prevention measures [16].…”

“…The use of repellent was the least practiced prevention method among participants in this study, while inspection of the body and wearing protective clothes were the most often used, which is in accordance with other studies [12,15,16,21]. The high cost of frequent use of repellent and concerns about its toxicity probably resulted in the rare use of these products [15].…”

“…The risk of tick bite among the population of the Lublin Province is very high, almost twice as high as in the LB endemic regions of France [15], and much higher than reported in other studies from Poland [12,16]. Also, as stated, men were more often exposed to tick bites than women, and occupational exposure was not significantly higher than during recreational activities.…”

“…Unfortunately, knowledge about the curability of LB was low even after education. In another survey in the endemic area of Poland, a minority of participants were convinced that LB is a curable disease [16]. In the other study, a higher proportion of respondents answered that LB can be treated, but more than half of participants incorrectly chose long-term antibiotic treatment instead of short-term in the question about treating LB [17].…”