Increased awareness and knowledge of Lyme Borreliosis and tick bite prevention among the general population in France: 2016 and 2019 health barometer survey

Abstract

Background Lyme borreliosis (LB) is the most frequent tick-borne disease in France. In the absence of a vaccine, LB prevention mainly relies on reducing tick bites. In 2016, the French Ministry of Health launched a national plan against tick-borne infections, including a prevention component. To evaluate the impact of this prevention strategy, we assessed knowledge and practices of tick bite prevention using the 2016 and 2019 national surveys on health attitudes and beliefs known as the French Health Barometer. Methods The Health Barometer is a repeated nationwide phone survey conducted annually on a random sample aged 18 to 75 years living in mainland France. In 2016 and 2019, participants were asked, among others, about their exposure to ticks, their behavior and practices regarding tick bites, and their knowledge about LB and its prevention. Results In 2019, 30% of the population reported a lifetime tick bite and 6% in the last year, an increase from 25% and 4%, respectively, in 2016 (p < 0.001). In 2019, 25% of the population felt exposed to tick bites compared to 23% in 2016 (p < 0.001). The proportion of participants who had heard about LB and who considered themselves well informed respectively increased from 66% and 29% in 2016 to 79% and 41% in 2019, (p < 0.001). In 2019 compared to 2016, a greater part of the French population applied protective measures against tick bites, particularly wearing protective clothing (74% vs 66%, p < 0.001) and regular tick checks and prompt tick removal after exposure (54% vs 47%, p < 0.001). Conclusions A substantial proportion of French residents are exposed to tick bites and apply protective measures. Our findings indicate a trend toward an increased knowledge and awareness of tick bites and LB between 2016 and 2019 in France. Our results can be used to target future information campaigns to specific age groups or at-risk areas in addition to the general population. However, we need to further study the barriers to the use of preventive measures.

Seroprevalence of Hantavirus in Forestry Workers, Northern France, 2019–2020

“…Indeed, there are specific HFRS prevention campaigns targeting forestry workers, as it is part of the list of occupational diseases in France [ 38 ]. Moreover, a previous French study indicated that forestry workers had greater knowledge about tick-borne diseases and were more likely to protect themselves than the general French population [ 39 ], indicating that they do follow recommendations and have a better knowledge of occupational diseases than the general population. Since the original study was aimed at investigating the seroprevalence of B. burgdorferi sl, we did not collect information on the use of preventive measures for hantavirus infections (such as the use of masks while working), and we could not evaluate their relationship with hantavirus seroprevalence.…”

Epidemiology of Lyme Borreliosis in France in Primary Care and Hospital Settings, 2010–2019

“…Age-specific analysis indicated children and older adults are particularly at risk of LB. Hypotheses for this finding include higher exposure to ticks among certain age groups, absence of careful body inspection for ticks after returning from outdoor activities (Septfons et al, 2021 ), and increasing susceptibility to developing LB symptoms with age (Oosting et al, 2016 ). Of interest, hospitalization is particularly frequent in 5–9 years of age compared with primary care incidence.…”

“…Although Limousin is a rural region characterized by a low population density and is heavily forested, these characteristics are not unique to Limousin. According to a population survey, Limousin had the highest proportion of its population bitten by a tick, in 2016 and 2019, which may indicate a higher density of ticks in this region or a higher proportion of its population may engage in activities placing them at risk of being bitten by ticks ( e.g ., forest activities) (Septfons et al, 2021 ). Data from primary care and hospitalizations were consistent across regions, suggesting the criteria used to extract LB data from the PMSI database, although not disease-specific and highly dependent on coding practice, may correctly capture the relative regional trends in LB cases.…”

Design theory to better target public health priorities: An application to Lyme disease in France

“…This requires understanding how citizens get access to information, integrate it, and modify their behavior ( 65 , 66 ), such as what has been developed for malaria prevention where for instance, an approach combining mass and interpersonal methods result in the positive improvement of prevention [e.g., ( 67 , 68 )]. Septfons et al ( 69 ) reported a trend toward increased knowledge and awareness of tick bites and LD from 2016 to 2019 in France. Indeed, in 2016 66% of participants had heard about LD.…”