Dataset Information

Discrepancies between self-reported tick bites and evidence of tick-borne disease exposure among nomadic Mongolian herders.

ABSTRACT: Twenty-six per cent of Mongolians live pastoral lifestyles, increasing their likelihood of exposure to ticks and placing them at a higher risk for contracting tick-borne diseases (TBDs). Anaplasma spp. and Rickettsia spp. have been identified in ticks, livestock and humans in Mongolia, but no known qualitative research has been conducted investigating the association between nomadic herder characteristics, tick bite history and exposure to TBDs. To better understand the association between self-reported tick bites and symptoms versus actual exposure to TBDs, this study paired serological data with 335 surveys administered to Mongolian herders, ages 12-69, from 2014 to 2015. Logistic regression results identified no significant associations between reported tick bites or symptoms with serological evidence of Anaplasma spp. and Rickettsia spp. controlling for age, gender and aimag. Among the 335 respondents who were seropositive to either Anaplasma spp. or Rickettsia spp., 32.9% self-reported experiencing abnormal symptoms such as redness, inflammation, headache, arthritis or fever after being bitten. Alternatively, 17.3% (58/335) of individuals reported experiencing symptoms following a tick bite in instances where serological results indicated no exposure to Anaplasma spp. or Rickettsia spp. Results also identified inconsistencies in reporting and seroprevalence among different age groups, with children having the highest reporting and treatment seeking rates but low levels of exposure in comparison with other groups. While survey results showed that individuals were aware of peak tick seasons and tick species that inhabit specific areas, 58% of heads of households (49/84) were unaware that ticks can cause disease in livestock or dogs. This study suggests that herders are an at-risk population in Mongolia with gaps in awareness of TBD risk. Increased surveillance paired with focused outreach to prevent TBDs targeted to the herder population is encouraged.

SUBMITTER: Lkhagvatseren S

PROVIDER: S-EPMC6629472 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Discrepancies between self-reported tick bites and evidence of tick-borne disease exposure among nomadic Mongolian herders.

Lkhagvatseren Sukhbaatar S Hogan Kathryn M KM Boldbaatar Bazartseren B von Fricken Michael E ME Anderson Benjamin D BD Pulscher Laura A LA Caddell Luke L Nymadawa Pagbajabyn P Gray Gregory C GC

Zoonoses and public health 20190410 5

Twenty-six per cent of Mongolians live pastoral lifestyles, increasing their likelihood of exposure to ticks and placing them at a higher risk for contracting tick-borne diseases (TBDs). Anaplasma spp. and Rickettsia spp. have been identified in ticks, livestock and humans in Mongolia, but no known qualitative research has been conducted investigating the association between nomadic herder characteristics, tick bite history and exposure to TBDs. To better understand the association between self- ...[more]

PMID: 30969028

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Project description:BackgroundTick-borne diseases are the most prevalent vector-borne diseases in Europe. Knowledge on the incidence and clinical presentation of other tick-borne diseases than Lyme borreliosis and tick-borne encephalitis is minimal, despite the high human exposure to these pathogens through tick bites. Using molecular detection techniques, the frequency of tick-borne infections after exposure through tick bites was estimated.MethodsTicks, blood samples and questionnaires on health status were collected from patients that visited their general practitioner with a tick bite or erythema migrans in 2007 and 2008. The presence of several tick-borne pathogens in 314 ticks and 626 blood samples of this cohort were analyzed using PCR-based methods. Using multivariate logistic regression, associations were explored between pathogens detected in blood and self-reported symptoms at enrolment and during a three-month follow-up period.ResultsHalf of the ticks removed from humans tested positive for Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum, Candidatus Neoehrlichia mikurensis, Rickettsia helvetica, Rickettsia monacensis, Borrelia miyamotoi and several Babesia species. Among 92 Borrelia burgdorferi s. l. positive ticks, 33% carried another pathogen from a different genus. In blood of sixteen out of 626 persons with tick bites or erythema migrans, DNA was detected from Candidatus Neoehrlichia mikurensis (n = 7), Anaplasma phagocytophilum (n = 5), Babesia divergens (n = 3), Borrelia miyamotoi (n = 1) and Borrelia burgdorferi s. l. (n = 1). None of these sixteen individuals reported any overt symptoms that would indicate a corresponding illness during the three-month follow-up period. No associations were found between the presence of pathogen DNA in blood and; self-reported symptoms, with pathogen DNA in the corresponding ticks (n = 8), reported tick attachment duration, tick engorgement, or antibiotic treatment at enrolment.ConclusionsBased on molecular detection techniques, the probability of infection with a tick-borne pathogen other than Lyme spirochetes after a tick bite is roughly 2.4%, in the Netherlands. Similarly, among patients with erythema migrans, the probability of a co-infection with another tick-borne pathogen is approximately 2.7%. How often these infections cause disease symptoms or to what extend co-infections affect the course of Lyme borreliosis needs further investigations.

Project description:The livestock industry in Mongolia accounts for 24% of national revenue, with one third of the population maintaining a pastoral lifestyle. This close connection between Mongolian population and livestock is a major concern for pathogen transfer, especially given the increase in vector-borne diseases globally. This study examines blood samples from livestock to assess the prevalence of tick-borne bacterial infections across three provinces in Mongolia (Dornogovi, Selenge, Töv). Whole blood samples from 243 livestock (cattle=38, camel=11, goat=85, horse=22, sheep=87) were analyzed with 16S metagenomics next-generation sequencing (NGS) to screen for bacterial pathogens. Positive-NGS samples for Anaplasma, Bartonella, Ehrlichia, Francisella, Leptospira, and Rickettsia were confirmed by conventional PCR and DNA sequencing. Prevalence rates of Anaplasma, Bartonella, and Ehrlichia were 57.6%, 12.8%, and 0.4%, respectively. A significant difference in the prevalence of Anaplasma spp. in livestock by province was observed, with a higher prevalence in Selenge (74.2%, p<0.001) and Töv (64.2% p = 0.006) compared to the semi-arid region of Dornogovi (39.8%). In contrast, no association was observed in Bartonella prevalence by provinces. All Anaplasma sequences (N = 139) were characterized as A. ovis. For Bartonella species characterization, phylogenetic analyses of gltA and rpoB genes identified three Bartonella species including B. bovis, B. melophagi and Candidatus B. ovis. Bartonella bovis was detected in all 22-positive cattle, while B. melophagi and Candidatus B. ovis were found in four and three sheep, respectively. This study identifies a high prevalence of tick-borne pathogens within the livestock population and to our knowledge, is the first time NGS methods have been used to explore tick-borne diseases in Mongolia. Further research is needed in Mongolia to better understand the clinical and economic burdens associated with tick-borne diseases in both livestock and pastoral herder populations.

Project description:Background There is a high prevalence of financial conflicts of interest (COI) between physicians and industry. Objectives To conduct a systematic review with meta-analysis examining the completeness of self-reported financial COI disclosures by physicians, and identify factors associated with non-disclosure. Data sources MEDLINE, Embase and PsycINFO were searched for eligible studies up to April 2020 and supplemented with material identified in the references and citing articles. Data extraction and synthesis Data were independently abstracted by two authors. Data synthesis was performed via systematic review of eligible studies and random-effects meta-analysis. Main outcomes and measures The proportion of discrepancies between physician self-reported disclosures and objective payment data was the main outcome. The proportion of discrepant funds and factors associated with non-disclosure were also examined. Results 40 studies were included. The pooled proportion of COI discrepancies at the article level was 81% (range: 54%–98%; 95% CI 72% to 89%), 79% at the payment level (range: 71%–89%; 95% CI 67% to 89%), 93% at the authorship level (range: 71%–100%; 95% CI 79% to 100%) and 66% at the author level (range: 8%–99%; 95% CI 48% to 78%). The proportion of funds discrepant was 33% (range: 2%–77%; 95% CI 12% to 58%). There was high heterogeneity between studies across all five analyses (I2=94%–99%). Most undisclosed COI were related to food and beverage, or travel and lodging. While the most common explanation for failure to disclose was perceived irrelevance, a median of 45% of non-disclosed payments were directly or indirectly related to the work. A smaller monetary amount was the most common factor associated with nondisclosure. Conclusions Physician self-reports of financial COI are highly discrepant with objective data sources reporting payments from industry. Stronger policies are required to reduce reliance on physician self-reporting of financial COI and address non-compliance.

Dataset Information

Discrepancies between self-reported tick bites and evidence of tick-borne disease exposure among nomadic Mongolian herders.

Publications

Discrepancies between self-reported tick bites and evidence of tick-borne disease exposure among nomadic Mongolian herders.

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