Rurality, Socioeconomic Status, and Residence in Environmental Risk Areas Associated with Increased Lyme Disease Incidence in Ontario, Canada: A Case-Control Study.
Vector Borne Zoonotic Dis
; 22(12): 572-581, 2022 12.
Article
in En
| MEDLINE
| ID: mdl-36378243
ABSTRACT
Background:
Lyme disease (LD) is the most common tick-borne illness in North America. LD is acquired through exposure to the tick vector, Ixodes scapularis, known as the blacklegged tick. In Canada, LD is rapidly emerging, with the establishment of I. scapularis in many newly endemic regions posing a growing risk to local communities. In the Canadian context, many environmental and socioeconomic risk factors for human LD infection are yet to be ascertained and the degree of risk associated with residential and community exposure to ticks is not well known.Methods:
We conducted a matched case-control study in southeastern Ontario, using LD patient data from provincial laboratory databases and uninfected population controls from 2014 to 2018. We aimed to identify area-level risk factors for LD and associations with residence in environmental risk areas, defined as areas with high model-predicted probability of I. scapularis occurrence, using the neighborhood dissemination area as the unit of analysis.Results:
Using multivariable conditional logistic regression analysis, we identified that patients with LD had higher odds (odds ratio, OR; 95% confidence interval, CI) of living in neighborhoods with high probability of tick occurrence in the environment (OR = 2.2; 95% CI 2.0-2.5), low walkability (OR = 1.6; 95% CI 1.2-2.1), low material deprivation (OR = 1.4; 95% CI 1.2-1.7), and low ethnic concentration (OR = 8.1; 95% CI 6.7-9.9). We also found that the odds of LD infection for individuals residing in environmental risk areas was highest for those living in public health units (PHUs) with <250,000 population (OR = 3.0; 95% CI 2.4-3.9) compared to those living in PHUs with >1,000,000 population (OR = 1.5; 95% CI 1.1-2.1).Conclusion:
This study shows that odds of human LD infection in Ontario, Canada is higher in less urbanized areas with higher socioeconomic status and indicates that exposure to ticks around the home residence or neighborhood is linked to increased odds of LD.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Social Class
/
Lyme Disease
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
Limits:
Animals
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
Vector Borne Zoonotic Dis
Journal subject:
DOENCAS TRANSMISSIVEIS
/
EPIDEMIOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Canadá