Behavioural and environmental factors associated with the risk of human tick bites in the Grippenet/Covidnet cohort in France
摘要
Ticks are one of the most important vectors of infectious disease pathogens in Europe, posing threats to human health. However, human exposure to tick bites and associated factors remains poorly documented, despite its importance to better mitigate the risk of tick-borne diseases. Current participatory datasets report information from individuals being bitten by ticks, while information on exposed but non-bitten individuals is scarce. Here, by collecting data on exposed individuals from a nationwide participatory surveillance cohort in France, we assessed the risk of self-reporting tick bites, and explored associated factors.
MethodsWe conducted a longitudinal study within the Grippenet/Covidnet cohort from November 2022 to February 2025, using online surveys sent every four months, and collected data on participants’ tick-bite experiences and related behaviours. We estimated the incidence of participants self-reporting at least one tick bite over a year. We then fitted a two-part Bayesian model using Integrated Nested Laplace Approximation (INLA) to look at factors associated with being bitten at least once and, among bitten participants, factors associated with an increased number of tick-bite episodes.
ResultsThe reported number of tick bites showed a seasonality with peaks occurring in June 2023 and 2024. We estimated the annual incidences of participants reporting at least one tick bite at 5,615 (95% CI [4,910-6,321]) and 5,402 (95% CI [4,670-6,133]) per 100,000 inhabitants in 2023 and 2024, respectively. Our model showed that factors positively associated with reporting a tick bite included being female, living in Grand Est region, having a green outdoor area at home, with an average temperature above 7 °C and higher percentage of forest and seminatural areas near the residence, having outdoor activity in green areas more than once a week, and visiting forest or meadow. The use of prevention measures was also associated with tick-bite reporting, which might reflect greater awareness of ticks or higher outdoor exposure. Factors associated with a higher number of self-reported tick bites were getting bitten in forest, meadow, or private garden, using prevention measures, and removing at least one tick after 24 h.
ConclusionWe present a nationwide and seasonal study providing baseline quantitative estimates of human behavioural and environmental factors associated with tick-bite reporting. Combined with other nationally collected data sources related to tick bites, for example providing data on tick species or at a higher resolution, this study could contribute to better inform prevention efforts.