Surgical or professional removal of ixodes ticks: evaluation of need and perception of necessity by Ukrainian population

Abstract

Tick bites are becoming a significant problem in Ukraine among adults and children, which can get tick-borne diseases through visits to the woody areas. Different tick removal techniques are well known, but professional removal is preferred to avoid further complications. Purpose - to analyze questionnaire performed among forestry workers of seven regions of Ukraine on correlation of professional tick removal with further medical complications and other factors, such as sex, number of bites, repellent use, skin self-inspection, awareness and age, and to review general recommendations and methods of tick removal, including professional / surgical ones. Materials and methods. Answers of 670 persons (611 males and 59 females), who were bitten by ticks, were analyzed. All respondents were tested for Lyme borreliosis by the enzyme-linked immunosorbent assay specific IgM and IgG antibodies against B. burgdorferi method. Two by two contingency tables were built to analyze factors that may lead to the seeking of professional tick removal and to analyze consequences of self-removal. Pearson chi-squared tests at p<0.05 and odds ratios with the confidence intervals (α=95%) were calculated to test for association and its strength. Spearman correlation value (p<0.05) between age and seeking of professional tick removal was calculated. Results. Only 7.3% of forestry workers (7.0% males and 10.2% females) visited medical establishments to professionally remove attached ticks. Forestry workers with high awareness were more likely to seek professional help for tick removal (p<0.05). Almost half (44.6%) of the forestry workers claimed to remove ticks with bare fingers, with 7.9% - by scratching away and 22.4% - by twisting out; 23.7% of all forestry workers used oil to suffocate ticks, all of which is not recommended. Only 32.2% of forestry workers used disinfectants after tick removal. The odds of LB positive results among foresters who sought professional tick removal was 0.47 times of the odds among foresters, which did not seek. Conclusions. To summarize, forestry workers and other sensitive population should be better educated regarding benefits of seeking professional tick removal. Moreover, seeking immediate professional medical help may also improve treatment of further medical complications in case of borrelia infection, as the doctor at the trauma center may explain symptoms of Lyme borreliosis and further sequence of actions for the patient. The surgical procedure for tick removal is described in literature, may decrease chances of tick-borne diseases spread, and should be considered for further implementation at Ukrainian medical establishments. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.