Rurality, Socioeconomic Status, and Residence in Environmental Risk Areas Associated with Increased Lyme Disease Incidence in Ontario, Canada: A Case-Control Study
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...
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| Veröffentlicht in: | Vector borne and zoonotic diseases (Larchmont, N.Y.) N.Y.), 2022-12, Vol.22 (12), p.572-581 |
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| creator | Slatculescu, Andreea M Pugliese, Michael Sander, Beate Zinszer, Kate Nelder, Mark P Russell, Curtis B Kulkarni, Manisha A |
| description | 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 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. |
| doi_str_mv | 10.1089/vbz.2022.0044 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2747596987</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2747596987</sourcerecordid><originalsourceid>FETCH-LOGICAL-c404t-fc56f2ecefe2933e0f0b594bd6175abf40bed45c5ea1fd01619cce2caa974bfa3</originalsourceid><addsrcrecordid>eNqFkU9rFDEYh4MotlaPXiXgdWfN38mOt2WtWlgobPU8ZJI3mDqT1CTTsn4dv6gZturRU973x8OTkB9CrylZU7Lp3t0PP9eMMLYmRIgn6JxKqRqlZPd0mTlpeNuqM_Qi51tCGN1Q-Ryd8ZarDRP8HP06zEmPvhxX-CYaH8HEECdv8E3RZc4rrIPFB8jeQjCAfcCX4d6nGCYIRY_44PN3vE2gM97mXA26gMUPvnzDV8EseV33xwnwB5-XbYn_ya6rJPm4wjsdtNXv8bZOGZpdDCXFsb5itseX6JnTY4ZXj-cF-vrx8svuc7O__nS12-4bI4gojTOydQwMOGAd50AcGWQnBttSJfXgBBnACmkkaOosoS3tjAFmtO6UGJzmF-jtyXuX4o8Zculv45xCvbJnStQvbbuNqlRzokyKOSdw_V3yk07HnpJ-qaSvlfRLJf1SSeXfPFrnYQL7l_7TQQX4CVhiHcLoYYBU_qP9DUQam3k</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2747596987</pqid></control><display><type>article</type><title>Rurality, Socioeconomic Status, and Residence in Environmental Risk Areas Associated with Increased Lyme Disease Incidence in Ontario, Canada: A Case-Control Study</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Slatculescu, Andreea M ; Pugliese, Michael ; Sander, Beate ; Zinszer, Kate ; Nelder, Mark P ; Russell, Curtis B ; Kulkarni, Manisha A</creator><creatorcontrib>Slatculescu, Andreea M ; Pugliese, Michael ; Sander, Beate ; Zinszer, Kate ; Nelder, Mark P ; Russell, Curtis B ; Kulkarni, Manisha A</creatorcontrib><description>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.</description><identifier>ISSN: 1530-3667</identifier><identifier>EISSN: 1557-7759</identifier><identifier>DOI: 10.1089/vbz.2022.0044</identifier><identifier>PMID: 36378243</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc., publishers</publisher><subject>Animals ; Arachnids ; Case-Control Studies ; Confidence intervals ; Deprivation ; Disease control ; Environmental risk ; Ethnic factors ; Exposure ; Humans ; Infections ; Local communities ; Lyme disease ; Lyme Disease - epidemiology ; Lyme Disease - veterinary ; Neighborhoods ; Ontario - epidemiology ; Original Articles ; Population control ; Public health ; Regression analysis ; Residential communities ; Risk analysis ; Risk factors ; Social Class ; Socioeconomic Factors ; Socioeconomic status ; Socioeconomics ; Statistical analysis ; Ticks ; Vector-borne diseases</subject><ispartof>Vector borne and zoonotic diseases (Larchmont, N.Y.), 2022-12, Vol.22 (12), p.572-581</ispartof><rights>Andreea M. Slatculescu et al. 2022; Published by Mary Ann Liebert, Inc.</rights><rights>Copyright Mary Ann Liebert, Inc. Dec 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-fc56f2ecefe2933e0f0b594bd6175abf40bed45c5ea1fd01619cce2caa974bfa3</citedby><cites>FETCH-LOGICAL-c404t-fc56f2ecefe2933e0f0b594bd6175abf40bed45c5ea1fd01619cce2caa974bfa3</cites><orcidid>0000-0001-5234-2211 ; 0000-0002-5084-4960</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36378243$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Slatculescu, Andreea M</creatorcontrib><creatorcontrib>Pugliese, Michael</creatorcontrib><creatorcontrib>Sander, Beate</creatorcontrib><creatorcontrib>Zinszer, Kate</creatorcontrib><creatorcontrib>Nelder, Mark P</creatorcontrib><creatorcontrib>Russell, Curtis B</creatorcontrib><creatorcontrib>Kulkarni, Manisha A</creatorcontrib><title>Rurality, Socioeconomic Status, and Residence in Environmental Risk Areas Associated with Increased Lyme Disease Incidence in Ontario, Canada: A Case-Control Study</title><title>Vector borne and zoonotic diseases (Larchmont, N.Y.)</title><addtitle>Vector Borne Zoonotic Dis</addtitle><description>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.</description><subject>Animals</subject><subject>Arachnids</subject><subject>Case-Control Studies</subject><subject>Confidence intervals</subject><subject>Deprivation</subject><subject>Disease control</subject><subject>Environmental risk</subject><subject>Ethnic factors</subject><subject>Exposure</subject><subject>Humans</subject><subject>Infections</subject><subject>Local communities</subject><subject>Lyme disease</subject><subject>Lyme Disease - epidemiology</subject><subject>Lyme Disease - veterinary</subject><subject>Neighborhoods</subject><subject>Ontario - epidemiology</subject><subject>Original Articles</subject><subject>Population control</subject><subject>Public health</subject><subject>Regression analysis</subject><subject>Residential communities</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Social Class</subject><subject>Socioeconomic Factors</subject><subject>Socioeconomic status</subject><subject>Socioeconomics</subject><subject>Statistical analysis</subject><subject>Ticks</subject><subject>Vector-borne diseases</subject><issn>1530-3667</issn><issn>1557-7759</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>1-M</sourceid><sourceid>EIF</sourceid><recordid>eNqFkU9rFDEYh4MotlaPXiXgdWfN38mOt2WtWlgobPU8ZJI3mDqT1CTTsn4dv6gZturRU973x8OTkB9CrylZU7Lp3t0PP9eMMLYmRIgn6JxKqRqlZPd0mTlpeNuqM_Qi51tCGN1Q-Ryd8ZarDRP8HP06zEmPvhxX-CYaH8HEECdv8E3RZc4rrIPFB8jeQjCAfcCX4d6nGCYIRY_44PN3vE2gM97mXA26gMUPvnzDV8EseV33xwnwB5-XbYn_ya6rJPm4wjsdtNXv8bZOGZpdDCXFsb5itseX6JnTY4ZXj-cF-vrx8svuc7O__nS12-4bI4gojTOydQwMOGAd50AcGWQnBttSJfXgBBnACmkkaOosoS3tjAFmtO6UGJzmF-jtyXuX4o8Zculv45xCvbJnStQvbbuNqlRzokyKOSdw_V3yk07HnpJ-qaSvlfRLJf1SSeXfPFrnYQL7l_7TQQX4CVhiHcLoYYBU_qP9DUQam3k</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Slatculescu, Andreea M</creator><creator>Pugliese, Michael</creator><creator>Sander, Beate</creator><creator>Zinszer, Kate</creator><creator>Nelder, Mark P</creator><creator>Russell, Curtis B</creator><creator>Kulkarni, Manisha A</creator><general>Mary Ann Liebert, Inc., publishers</general><general>Mary Ann Liebert, Inc</general><scope>1-M</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7SS</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>M7N</scope><orcidid>https://orcid.org/0000-0001-5234-2211</orcidid><orcidid>https://orcid.org/0000-0002-5084-4960</orcidid></search><sort><creationdate>20221201</creationdate><title>Rurality, Socioeconomic Status, and Residence in Environmental Risk Areas Associated with Increased Lyme Disease Incidence in Ontario, Canada: A Case-Control Study</title><author>Slatculescu, Andreea M ; Pugliese, Michael ; Sander, Beate ; Zinszer, Kate ; Nelder, Mark P ; Russell, Curtis B ; Kulkarni, Manisha A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-fc56f2ecefe2933e0f0b594bd6175abf40bed45c5ea1fd01619cce2caa974bfa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Animals</topic><topic>Arachnids</topic><topic>Case-Control Studies</topic><topic>Confidence intervals</topic><topic>Deprivation</topic><topic>Disease control</topic><topic>Environmental risk</topic><topic>Ethnic factors</topic><topic>Exposure</topic><topic>Humans</topic><topic>Infections</topic><topic>Local communities</topic><topic>Lyme disease</topic><topic>Lyme Disease - epidemiology</topic><topic>Lyme Disease - veterinary</topic><topic>Neighborhoods</topic><topic>Ontario - epidemiology</topic><topic>Original Articles</topic><topic>Population control</topic><topic>Public health</topic><topic>Regression analysis</topic><topic>Residential communities</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Social Class</topic><topic>Socioeconomic Factors</topic><topic>Socioeconomic status</topic><topic>Socioeconomics</topic><topic>Statistical analysis</topic><topic>Ticks</topic><topic>Vector-borne diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Slatculescu, Andreea M</creatorcontrib><creatorcontrib>Pugliese, Michael</creatorcontrib><creatorcontrib>Sander, Beate</creatorcontrib><creatorcontrib>Zinszer, Kate</creatorcontrib><creatorcontrib>Nelder, Mark P</creatorcontrib><creatorcontrib>Russell, Curtis B</creatorcontrib><creatorcontrib>Kulkarni, Manisha A</creatorcontrib><collection>Mary Ann Liebert Online - Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><jtitle>Vector borne and zoonotic diseases (Larchmont, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Slatculescu, Andreea M</au><au>Pugliese, Michael</au><au>Sander, Beate</au><au>Zinszer, Kate</au><au>Nelder, Mark P</au><au>Russell, Curtis B</au><au>Kulkarni, Manisha A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rurality, Socioeconomic Status, and Residence in Environmental Risk Areas Associated with Increased Lyme Disease Incidence in Ontario, Canada: A Case-Control Study</atitle><jtitle>Vector borne and zoonotic diseases (Larchmont, N.Y.)</jtitle><addtitle>Vector Borne Zoonotic Dis</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>22</volume><issue>12</issue><spage>572</spage><epage>581</epage><pages>572-581</pages><issn>1530-3667</issn><eissn>1557-7759</eissn><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.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc., publishers</pub><pmid>36378243</pmid><doi>10.1089/vbz.2022.0044</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5234-2211</orcidid><orcidid>https://orcid.org/0000-0002-5084-4960</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Animals Arachnids Case-Control Studies Confidence intervals Deprivation Disease control Environmental risk Ethnic factors Exposure Humans Infections Local communities Lyme disease Lyme Disease - epidemiology Lyme Disease - veterinary Neighborhoods Ontario - epidemiology Original Articles Population control Public health Regression analysis Residential communities Risk analysis Risk factors Social Class Socioeconomic Factors Socioeconomic status Socioeconomics Statistical analysis Ticks Vector-borne diseases |
| title | Rurality, Socioeconomic Status, and Residence in Environmental Risk Areas Associated with Increased Lyme Disease Incidence in Ontario, Canada: A Case-Control Study |
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