Comparing the effect of a leaflet and a movie in preventing tick bites and Lyme disease in The Netherlands

Abstract Background Lyme disease (LD) has become the most common vector borne illness in the Northern hemisphere. Prevention relies predominantly on fostering protective behaviors (e.g., avoiding tick areas, using protective clothing and repellent, and doing routine tick checks post-exposure). The objective of this study was to evaluate the effectiveness (in terms of knowledge, perceived severity and susceptibility, self-efficacy, response efficacy, intention, and behavior over time) and appreciation of a leaflet and a movie as tools for informing the public in the Netherlands about ticks and LD protective behaviors. Methods Participants (1,677 at t1 and 361 extra at t2) were members of a representative Internet panel (adults aged 18 years and above). A four group randomized controlled design was used to test the effect of an information leaflet and a movie (two intervention groups), compared to a control group and a follow-up only control group. Data were collected over two periods: July 15–29, 2013 (t1) and at follow-up 4 weeks later, August 16–31, 2013 (t2). Results Post-intervention results show all respondents in all groups possess good general basic knowledge of ticks and LD. Respondents in both the leaflet and movie groups knew more than respondents in the control group, and had greater awareness of best practices after a tick bite. Intention to perform protective behavior in future was stronger among respondents in the intervention groups. While respondents generally appreciated both the movie and the leaflet, they found the movie ran too long. Follow-up revealed no lasting positive effects from either the leaflet or the movie. Conclusions Our results suggest that both the movie and the leaflet are valued and effective intervention tools for improving knowledge about tick bites and strengthening self-efficacy and intentions to perform protective behavior against ticks and LD . Achieving lasting effects, however, calls for more action

Emergence of Methicillin-Resistant Staphylococcus aureus of Animal Origin in Humans

In 2003 in the Netherlands, a new methicillin-resistant Staphylococcus aureus (MRSA) strain emerged that could not be typed with Sma1 pulsed-field gel electrophoresis (NT-MRSA). The association of NT-MRSA in humans with a reservoir in animals was investigated. The frequency of NT-MRSA increased from 0% in 2002 to >21% after intensified surveillance was implemented in July 2006. Geographically, NT-MRSA clustered with pig farming. A case–control study showed that carriers of NT-MRSA were more often pig or cattle farmers (pig farmers odds ratio [OR] 12.2, 95% confidence interval [CI] 3.1–48.6; cattle farmers OR 19.7, 95% CI 2.3–169.5). Molecular typing showed that the NT-MRSA strains belonged to a new clonal complex, ST 398. This study shows that MRSA from an animal reservoir has recently entered the human population and is now responsible for >20% of all MRSA in the Netherlands

Determinants and protective behaviours regarding tick bites among school children in the Netherlands: a cross-sectional study

BACKGROUND: Lyme borreliosis (LB) is the most common tick-borne disease in the United States and Europe. The incidence is 13.4 per 100,000 inhabitants in the United States and more than 300 per 100,000 inhabitants in Europe. Children are at highest risk of LB. In the Netherlands in 2007, the incidence of tick bites in children between 10–14 years varied from 7,000 -11,000 per 100,000, depending on age. This study among Dutch school children aimed to examine the knowledge, perceived threat, and perceived importance of protective behaviour in relation to tick bites and their potential consequences. METHODS: In April 2012, the municipal health services (MHS) contacted primary schools to recruit children 9–13 years by telephone, e-mail, or advertisement in MHS newsletters. In total, 1,447 children from 40 schools participated in this study by completing a specifically developed and pretested compact paper questionnaire. Regression models were used to determine which covariates (e.g. forest cover, previous education, knowledge) are associated with our response variables. RESULTS: 70% (n = 1,015) of the children answered at least six out of seven knowledge questions correctly. The vast majority (93%; n = 1345) regarded body checks as very or somewhat important, 18% (n = 260) was routinely checked by their parents. More frequent body checks were associated with good knowledge about ticks and tick-borne diseases and knowing persons who got ill after tick bite. Children in areas with a higher forest cover were more likely to be checked frequently. CONCLUSIONS: Most children have a good knowledge of ticks and the potential consequences of tick bites. Knowing persons who personally got ill after tick-bite is associated with a good knowledge score and leads to higher susceptibility and better appreciation of the need for body checks. Perceived severity is associated with a good knowledge score and with knowing persons who got ill after tick-bite. Is seems to be useful to additionally address children in health education regarding ticks and tick-borne diseases. The relationship between health education programs for children (and their parents) about ticks and their possible consequences and prevention of these deserves further study