Detection of municipalities at-risk of Lyme disease using passive surveillance of Ixodes scapularis as an early signal: A province-specific indicator in Canada
Detection of municipalities at-risk of Lyme disease using passive surveillance of Ixodes scapularis as an early signal: A province-specific indicator in Canada
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DOI：
10.1371/journal.pone.0212637
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发表时间：
2019-02-19
期刊：
影响因子：
3.7
通讯作者：
Koffi, Jules K.
中科院分区：
文献类型：
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作者：
Gasmi, Salima;Ogden, Nicholas H.;Koffi, Jules K.
莱姆病是北美最常见的媒介传播疾病，由狭义伯氏疏螺旋体引起，在加拿大东部由肩胛硬蜱传播，在加拿大西部由太平洋硬蜱传播。近年来，该虫活动范围向北扩展，并有向北扩展的趋势。在加拿大东南部发现的肩胛蜱导致人类莱姆病发病率急剧增加。检测莱姆病风险的新领域使公共卫生能够针对疾病预防工作。我们分析了来自安大略和马尼托巴的被动蜱监测数据，以i）评估I.在被动监测中，评估了肩胛骨螨提交的来自人类的数据，以及人类莱姆病病例的数量，以及ii）制定了可用于生成基于监测的风险地图的省特异性风险螨学指标。我们还评估了若虫I的数量之间的关联。肩胛骨蜱只提交和莱姆病病例的发病率。用通用估计方程回归分析了I.肩胛肌附着两省各人口普查分区（CSD）的莱姆病（总数和仅限患病人数）与莱姆病报告人数呈正相关，且具有高度显著性（当使用蜱虫提交总数时，P = 3例莱姆病病例，来自具有< 3例病例的病例，具有高准确度（曲线下接受者操作特征面积[AUC] = 0.89））和中等精度（AUC = 0.78）时，使用若虫蜱提交。在安大略，最佳截止点为5年内从CSD提交的总共12只蜱（灵敏度= 0.82，特异性= 0.84），而在马尼托巴，截止点为5只蜱（灵敏度= 0.71，特异性= 0.79），表明从I.肩胛骨咬伤本研究中为安大略和马尼托巴开发的螨学指标的性能支持被动蜱监测的能力，以提供存在莱姆病风险地区的早期信号，在这些地区，蜱及其传播的病原体正在扩大其范围。
Lyme disease, the most commonly reported vector-borne disease in North America, is caused by the spirochete Borrelia burgdorferi sensu stricto, which is transmitted by Ixodes scapularis in eastern Canada and Ixodes pacificus in western Canada. Recently, the northward range expansion of I. scapularis ticks, in south-eastern Canada, has resulted in a dramatic increase in the incidence of human Lyme disease. Detecting emerging areas of Lyme disease risk allows public health to target disease prevention efforts. We analysed passive tick surveillance data from Ontario and Manitoba to i) assess the relationship between the total numbers of I. scapularis submissions in passive surveillance from humans, and the number of human Lyme disease cases, and ii) develop province-specific acarological indicators of risk that can be used to generate surveillance-based risk maps. We also assessed associations between numbers of nymphal I. scapularis tick submissions only and Lyme disease case incidence. Using General Estimating Equation regression, the relationship between I. scapularis submissions (total numbers and numbers of nymphs only) in each census sub-division (CSD) and the number of reported Lyme disease cases was positively correlated and highly significant in the two provinces (P = 3 Lyme disease cases from those with < 3 cases with high accuracy when using total numbers of tick submission (Receiver Operating Characteristics area under the curve [AUC] = 0.89) and moderate accuracy (AUC = 0.78) when using nymphal tick submissions only. In Ontario the optimal cut-off point was a total 12 tick submissions from a CSD over five years (Sensitivity = 0.82, Specificity = 0.84), while in Manitoba the cut-off point was five ticks (Sensitivity = 0.71, Specificity = 0.79) suggesting regional variability of the risk of acquiring Lyme disease from an I. scapularis bite. The performances of the acarological indicators developed in this study for Ontario and Manitoba support the ability of passive tick surveillance to provide an early signal of the existence Lyme disease risk areas in regions where ticks and the pathogens they transmit are expanding their range.