Assessing knowledge gaps and empowering Extension workers in Illinois with information on ticks and tickborne diseases through KAP surveys

Methods of active surveillance for hard ticks and associated tick-borne pathogens of public health importance in the contiguous United States: a comprehensive systematic review

Tick-borne diseases in humans and animals have increased prevalence across the United States. To understand risk factors underlying tick-borne diseases it is useful to conduct regular surveillance and monitoring of ticks and the pathogens they carry, in a sustained and effective manner. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, this study aims to summarize the previously used methods for active surveillance of ticks and tick-borne pathogens, identify the existing knowledge gaps in ongoing surveillance, and highlight and guide the mechanisms required to inform those gaps for more effective and sustainable future surveillance efforts. After screening 2,500 unique studies between 1944 and 2018, we found 646 articles that performed active surveillance of hard ticks and/or their associated tick-borne pathogens of public health importance within the United States. An additional 103 articles were included for the 2019 to 2023 period. Active surveillance has been performed in ~42% of the counties (1944 to 2018) and ~23% of the counties (2019 to 2023) within the contiguous US, and states with the most coverage are in the Northeast, Upper Midwest, and along the West coast. The most reported tick was Ixodes scapularis (195 studies) and most commonly reported pathogen was Borrelia burgdorferi (143 studies). Overall, surveillance efforts have increased and become more diversified, and methods of tick and tick-borne pathogens testing have undergone changes, but those efforts are mainly concentrated in focal regions of a county. Future surveillance efforts should follow Centers for Disease Control and Prevention guidelines and target areas of United States with scarce reports of active surveillance and build collaborations and resources to increase surveillance.

Development and validation of an enteral feeding interruption management scale for ICU medical staff: A knowledge-, attitude- and practice-based approach

BACKGROUND

Enteral feeding interruption (EFI) is a frequent issue in ICU settings, affecting nutritional adequacy and delaying recovery in critically ill patients. While tools exist to assess patients' nutritional status, no instrument evaluates ICU staff's knowledge, attitude and practice (KAP) in EFI management.

AIM

To develop a reliable and valid EFI management scale for ICU medical staff based on the KAP model.

STUDY DESIGN

This instrument development study followed the STROBE guidelines, utilizing a cross-sectional, multi-centre approach in Wuhan. A convenience sample of 400 ICU staff from eight tertiary A hospitals and two tertiary B hospitals was included between May 2021 and March 2022. A preliminary scale was constructed through literature review, interviews and expert consultations. The sample was used to assess the scale's reliability and validity.

RESULTS

The final EFI management scale comprised 41 items across three dimensions, with cumulative variance contributions of 70.341%, 70.437% and 66.550%. Cronbach's α ranged from 0.919 to 0.947, with test-retest reliability between 0.488 and 0.836. The total scale had a Cronbach's α of 0.953 and test-retest reliability of 0.977. Content validity indices (I-CVI) ranged from 0.800 to 1.000, and the scale-level CVI was 0.975.

CONCLUSIONS

The EFI Management KAP Scale is a valid, reliable tool for assessing ICU medical staff's management of EFI.

RELEVANCE TO CLINICAL PRACTICE

The EFI Management KAP Scale addresses a critical gap in the standardized evaluation of critical care nurses' knowledge, attitudes and practices regarding enteral feeding interruptions. By providing a validated tool, this scale enables the identification of specific barriers and facilitators to optimal enteral nutrition delivery in critically ill patients. Its application can guide targeted educational interventions, inform policy adjustments and enhance multidisciplinary collaboration in the ICU. Ultimately, this scale supports improved enteral nutrition management, reducing complications associated with feeding interruptions and contributing to better patient outcomes in critical care settings.

Assessment of the Knowledge, Attitude, and Perception (KAP) of Sheep Farmers Regarding Ticks and Tick-Borne Pathogens in Tunisia, North Africa

Ticks and tick-borne pathogens (TBPs) are a threat to human and animal health worldwide. A structured questionnaire was used to assess the knowledge, attitudes/practices, and perceptions (KAP) of 86 farmers of extensive sheep farming systems across different agro-ecological areas in Tunisia. The response rate was about 91.3%. Overall, 68.5% of the questions referring to knowledge and perceptions were answered correctly. Indeed, about half of the respondents were aware that ticks infest animals, with weight loss given as the major consequence. However, more than half of the farmers were unaware of the transmission and vectorial role of ticks. Those who knew that ticks are vectors cited microbes and icterus as the main concerns. A broad majority of farmers (70.9%) stated that they removed the attached ticks manually and 45.3% crushed them. As acaricides were perceived to be efficient for fighting ticks, according to 97.7% of the sheep farmers, they were used for both the animals and their sleeping areas. Although the toxicity of acaricides is known, 59.3% of the respondents did not use personal protection equipment when applying these products. Taken together, gaps in KAP among sheep farmers were identified. It can be used to better design awareness communication tools for TBPs.

Outdoor worker knowledge of ticks and Lyme disease in Québec

BACKGROUND AND AIMS

Lyme disease is a well-known occupational risk across North America caused by exposure to Borrelia burgdorferi via blacklegged ticks (Ixodes scapularis). As the geographic range of B. burgdorferi advances with the increasing distribution of blacklegged ticks, more outdoor workers are at risk of contracting Lyme disease. In this study, we examined the demography and personal perceptions of outdoor workers within one framework to better determine the overall risk for those working outdoors.

METHODS AND RESULTS

We analysed outdoor worker knowledge of ticks and of behaviours that can prevent tick bites and Lyme disease. We then compared these risk perceptions of individuals across age, sex, education, and industry, as well as time spent outdoors. We tested the hypothesis that the risk perception of an individual and their knowledge of Lyme disease transmission was dependent on their demographics, experience in their job, and the region in which they spend time outdoors. We estimated a knowledge-based risk score based on individuals' answers to a questionnaire on risk perception given to voluntary participants who work outdoors. Those who had higher risk scores were more at risk. We found that knowledge-based risk scores were correlated with geographic risk levels and with the number of hours per day spent outdoors. Those who work longer hours and who work in areas with mid-level risk had higher risk scores. Those who spend more time outdoors recreationally had lower risk scores.

CONCLUSIONS

Further examination and acknowledgment of the reasoning behind why these factors are affecting workers' risks must be considered to recognize that it is not necessarily demographics or geographically high-risk areas that affect an individual's risk. Workers' knowledge of these risks is affected by several variables that should be taken into consideration when implementing safety measures and awareness programs.

Unveiling Misconceptions among Small-Scale Farmers Regarding Ticks and Tick-Borne Diseases in Balochistan, Pakistan

Ticks and tick-borne diseases (TBDs) pose potential health threats to small-scale farmers of grazing animals in the upper highlands of Balochistan, Pakistan. This study was conducted based on a questionnaire survey involving 153 farmers of grazing animals in seven districts to access their knowledge, attitudes, and practices regarding ticks and TBDs. Odds ratios and 95% confidence intervals, based on Fisher's test, were used to assess risk factors for determining preventive measures. The findings revealed a low level of knowledge among the participants. For instance, there was a lack of awareness of the effects of climate change and the economic impact of ticks on animal health. The essential precautions, such as the non-indiscriminate use of acaricides, wearing dark-colored clothing, and limiting children's interaction with grazing animals, were often overlooked. However, the farmers had a positive attitude towards tick control, but they mostly relied on the knowledge of local communities. The neglect of such measures places these farmers and their children at risk of contracting TBDs. This study also indicates minimal involvement from the government in educating farmers and controlling ticks. The role of stakeholders, including the government, non-governmental organizations, veterinary doctors, and local farmer communities, is crucial to address these issues and to implement effective training programs that address misconceptions about ticks and TBDs. Overall, this study highlights the importance of implementing awareness and education programs to address the misconceptions about ticks and TBDs among farmers.