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Integrated Assessment of Behavioral and Environmental Risk Factors for Lyme Disease Infection on Block Island Rhode Island

机译:罗德岛布洛克岛莱姆病感染行为和环境危险因素的综合评估

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摘要

Peridomestic exposure to Borrelia burgdorferi-infected Ixodes scapularis nymphs is considered the dominant means of infection with black-legged tick-borne pathogens in the eastern United States. Population level studies have detected a positive association between the density of infected nymphs and Lyme disease incidence. At a finer spatial scale within endemic communities, studies have focused on individual level risk behaviors, without accounting for differences in peridomestic nymphal density. This study simultaneously assessed the influence of peridomestic tick exposure risk and human behavior risk factors for Lyme disease infection on Block Island, Rhode Island. Tick exposure risk on Block Island properties was estimated using remotely sensed landscape metrics that strongly correlated with tick density at the individual property level. Behavioral risk factors and Lyme disease serology were assessed using a longitudinal serosurvey study. Significant factors associated with Lyme disease positive serology included one or more self-reported previous Lyme disease episodes, wearing protective clothing during outdoor activities, the average number of hours spent daily in tick habitat, the subject’s age and the density of shrub edges on the subject’s property. The best fit multivariate model included previous Lyme diagnoses and age. The strength of this association with previous Lyme disease suggests that the same sector of the population tends to be repeatedly infected. The second best multivariate model included a combination of environmental and behavioral factors, namely hours spent in vegetation, subject’s age, shrub edge density (increase risk) and wearing protective clothing (decrease risk). Our findings highlight the importance of concurrent evaluation of both environmental and behavioral factors to design interventions to reduce the risk of tick-borne infections.
机译:在美国东部,橄榄核感染伯氏疏螺旋体感染的肩x小若虫若虫的周界接触被认为是感染黑脚tick传播病原体的主要感染手段。人群水平研究发现,若虫若虫密度与莱姆病发病率呈正相关。在地方性社区内更精细的空间尺度上,研究集中在个体水平的风险行为上,而没有考虑到家中若虫密度的差异。这项研究同时评估了在罗德岛布洛克岛上,蠕虫暴露的腹壁tick暴露风险和人类行为危险因素的影响。使用与独立属性级别的刻度密度高度相关的遥感景观指标,估算了布洛克岛(Block Island)物业的刻度暴露风险。使用纵向血清调查研究评估行为危险因素和莱姆病血清学。与莱姆病阳性血清学有关的重要因素包括一个或多个自我报告的先前莱姆病发作,在户外活动中穿防护服,tick栖息地每天平均花费的小时数,受试者的年龄以及受试者的灌木边缘密度属性。最佳拟合多元模型包括以前的莱姆病诊断和年龄。与以前的莱姆病的这种关联的强度表明,人口的同一部分往往被反复感染。第二个最佳多元模型包括环境和行为因素的组合,即在植被上花费的时间,受试者的年龄,灌木边缘密度(增加风险)和穿着防护服(减少风险)。我们的发现凸显了同时评估环境和行为因素对设计干预措施以降低tick传播感染风险的重要性。

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