A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland.

<h4>Background</h4>Tick-borne encephalitis (TBE) is endemic to Europe and medically highly significant. This study, focused on Poland, investigated individual risk factors for TBE symptomatic infection.<h4>Methods and findings</h4>In a nation-wide population-based case-contro...

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Autores principales:	Pawel Stefanoff, Magdalena Rosinska, Steven Samuels, Dennis J White, Dale L Morse, Sarah E Randolph
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c310307a6b444f4cab5daffc5ab40ddc
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spelling	oai:doaj.org-article:c310307a6b444f4cab5daffc5ab40ddc2021-11-18T07:04:54ZA national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland.1932-620310.1371/journal.pone.0045511https://doaj.org/article/c310307a6b444f4cab5daffc5ab40ddc2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23029063/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Tick-borne encephalitis (TBE) is endemic to Europe and medically highly significant. This study, focused on Poland, investigated individual risk factors for TBE symptomatic infection.<h4>Methods and findings</h4>In a nation-wide population-based case-control study, of the 351 TBE cases reported to local health departments in Poland in 2009, 178 were included in the analysis. For controls, of 2704 subjects (matched to cases by age, sex, district of residence) selected at random from the national population register, two were interviewed for each case and a total of 327 were suitable for the analysis. Questionnaires yielded information on potential exposure to ticks during the six weeks (maximum incubation period) preceding disease onset in each case. Independent associations between disease and socio-economic factors and occupational or recreational exposure were assessed by conditional logistic regression, stratified according to residence in known endemic and non-endemic areas. Adjusted population attributable fractions (PAF) were computed for significant variables. In endemic areas, highest TBE risk was associated with spending ≥10 hours/week in mixed forests and harvesting forest foods (adjusted odds ratio 19.19 [95% CI: 1.72-214.32]; PAF 0.127 [0.064-0.193]), being unemployed (11.51 [2.84-46.59]; 0.109 [0.046-0.174]), or employed as a forester (8.96 [1.58-50.77]; 0.053 [0.011-0.100]) or non-specialized worker (5.39 [2.21-13.16]; 0.202 [0.090-0.282]). Other activities (swimming, camping and travel to non-endemic regions) reduced risk. Outside TBE endemic areas, risk was greater for those who spent ≥10 hours/week on recreation in mixed forests (7.18 [1.90-27.08]; 0.191 [0.065-0.304]) and visited known TBE endemic areas (4.65 [0.59-36.50]; 0.058 [-0.007-0.144]), while travel to other non-endemic areas reduced risk.<h4>Conclusions</h4>These socio-economic factors and associated human activities identified as risk factors for symptomatic TBE in Poland are consistent with results from previous correlational studies across eastern Europe, and allow public health interventions to be targeted at particularly vulnerable sections of the population.Pawel StefanoffMagdalena RosinskaSteven SamuelsDennis J WhiteDale L MorseSarah E RandolphPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 9, p e45511 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Pawel Stefanoff Magdalena Rosinska Steven Samuels Dennis J White Dale L Morse Sarah E Randolph A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland.
description	<h4>Background</h4>Tick-borne encephalitis (TBE) is endemic to Europe and medically highly significant. This study, focused on Poland, investigated individual risk factors for TBE symptomatic infection.<h4>Methods and findings</h4>In a nation-wide population-based case-control study, of the 351 TBE cases reported to local health departments in Poland in 2009, 178 were included in the analysis. For controls, of 2704 subjects (matched to cases by age, sex, district of residence) selected at random from the national population register, two were interviewed for each case and a total of 327 were suitable for the analysis. Questionnaires yielded information on potential exposure to ticks during the six weeks (maximum incubation period) preceding disease onset in each case. Independent associations between disease and socio-economic factors and occupational or recreational exposure were assessed by conditional logistic regression, stratified according to residence in known endemic and non-endemic areas. Adjusted population attributable fractions (PAF) were computed for significant variables. In endemic areas, highest TBE risk was associated with spending ≥10 hours/week in mixed forests and harvesting forest foods (adjusted odds ratio 19.19 [95% CI: 1.72-214.32]; PAF 0.127 [0.064-0.193]), being unemployed (11.51 [2.84-46.59]; 0.109 [0.046-0.174]), or employed as a forester (8.96 [1.58-50.77]; 0.053 [0.011-0.100]) or non-specialized worker (5.39 [2.21-13.16]; 0.202 [0.090-0.282]). Other activities (swimming, camping and travel to non-endemic regions) reduced risk. Outside TBE endemic areas, risk was greater for those who spent ≥10 hours/week on recreation in mixed forests (7.18 [1.90-27.08]; 0.191 [0.065-0.304]) and visited known TBE endemic areas (4.65 [0.59-36.50]; 0.058 [-0.007-0.144]), while travel to other non-endemic areas reduced risk.<h4>Conclusions</h4>These socio-economic factors and associated human activities identified as risk factors for symptomatic TBE in Poland are consistent with results from previous correlational studies across eastern Europe, and allow public health interventions to be targeted at particularly vulnerable sections of the population.
format	article
author	Pawel Stefanoff Magdalena Rosinska Steven Samuels Dennis J White Dale L Morse Sarah E Randolph
author_facet	Pawel Stefanoff Magdalena Rosinska Steven Samuels Dennis J White Dale L Morse Sarah E Randolph
author_sort	Pawel Stefanoff
title	A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland.
title_short	A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland.
title_full	A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland.
title_fullStr	A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland.
title_full_unstemmed	A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland.
title_sort	national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in poland.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/c310307a6b444f4cab5daffc5ab40ddc
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A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland.

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