Knowledge, protection behaviours and seroprevalence of Lyme borreliosis in inhabitants of Lublin Province, eastern Poland – evaluation of a prophylaxis programme
More details
Hide details
Department of Health Biohazards and Parasitology, Institute of Rural Health, Lublin, Poland
Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Puławy, Poland
Corresponding author
Violetta Zając   

Department of Health Biohazards and Parasitology, Institute of Rural Health, Lublin, Poland, Jaczewskiego 2, 20-090, Lublin, Poland
Ann Agric Environ Med. 2023;30(3):413-424
Introduction and objective:
Lyme borreliosis (LB) is the most frequent tick-borne disease with 17,338 cases reported in Poland in 2022. Since research on a LB vaccine is still ongoing, the promotion of individual behaviours and limiting of tick exposure is one of the most effective ways to prevent LB. The aim of the study was to evaluate the effectiveness of the LB prevention programme by assessing the knowledge, practice behaviours, seroprevalence of LB and satisfaction among the population of the Lublin Province in eastern Poland.

Material and methods:
The prevention programme was carried out among 2,920 participants who were asked about their exposure to ticks, history of LB and prevention behaviours. Awareness of knowledge was evaluated before and after training. Seroprevalence of LB was rated by ELISA and immunoblot assays.

Over 73% of participants reported tick bites in their lifetime, without significant differences between rural and urban area inhabitants. More than 80% of individuals declared that they use protective measures (PPM), such as proper clothes and body checking; repellents were the least frequently used by participants. The diagnosis of LB but not tick bites in a lifetime influenced the more frequent use of PPM. Increase in knowledge was observed in 86% of participants after education, and the highest knowledge was noted among respondents with higher education. The seroprevalence of anti-B. burgdorferi antibodies was 37% and was higher among men than women (40% vs. 36%).

The population of Lublin Province is highly exposed to tick bites and infection with B. burgdorferi. The high seroprevalence and increase in knowledge confirmed the effectiveness and need for preventive programmes. These results can be useful for optimizing and enhancing the effects of future prevention campaigns.

The study was supported by The European Social Fund and the project ‘Lyme borreliosis prevention among the inhabitants of the Lublin Province’ (RPLU.10.03.00-06- 0007/19), implemented under the Regional Operational Programme for the Lublin Province 2014 - 2020, Priority Axis 10 Adaptability of enterprises and employees to change, Investment Priority 8vi Active and healthy aging, Action: 10.3 Health policy programmes.
Beard CB, Hu LT, Hinckley AF, et al. Lyme Disease. Curr Epidemiol Rep. 2016;3:252–258.
Marques AR, Strle F, Wormser GP. Comparison of Lyme Disease in the United States and Europe. Emerg Infect Dis. 2021;27(8):2017–2024.
Vandekerckhove O, De Buck E, Van Wijngaerden E. Lyme disease in Western Europe: an emerging problem? A systematic review. Acta Clin Belg. 2021;76(3):244–252.
Bobe JR, Jutras BL, Horn EJ, et al. Recent Progress in Lyme Disease and Remaining Challenges. Front Med. 2021;8:666554.
Sykes RA, Makiello P. An estimate of Lyme borreliosis incidence in Western Europe. J Public Health (Oxf). 2017;39(1):74–81.
NIZP-PZH. Reports on cases of infectious diseases and poisonings in Poland, Warsaw, NIZP-PZH, GIS. http://wwwold.pzh. (access: 2023.04.28).
Blazhev A, Stanilov I, Miteva, LD, et al. Prevalence of Borrelia burgdorferi Sensu Lato in Ixodes ricinus Ticks Collected from Kaylaka Park in Pleven, Bulgaria. Microorganisms. 2022;10(4):772.
Rizzoli A, Hauffe H, Carpi G, et al. Lyme borreliosis in Europe. Euro Surveill. 2011;16(27):19906.
Sprong H, Azagi T, Hoornstra D, et al. Control of Lyme borreliosis and other Ixodes ricinus-borne diseases. Parasit Vectors. 2018;11(1):145.
Stanek G, Strle F. Lyme borreliosis-from tick bite to diagnosis and treatment. FEMS Microbiol Rev. 2018;42(3):233–258.
MedCalc® Statistical Software version 22.009 (MedCalc Software Ltd, Ostend, Belgium. (access 2023).
Buczek A, Pilch J, Buczek W. Tick Preventive Behaviors and Practices Adopted by Medical Students from Poland, Germany, and Thailand in Relation to Socio-Demographic Conditions and Their Knowledge of Ticks and Tick-Borne Diseases. Insects. 2020;11(12):863.
Schwartz AM, Mackeprang JM, Mead PS, et al. Effectiveness of personal protection measures against Lyme disease: A review of epidemiologic studies from the United States. Zoonoses Public Health. 2022;69(7):777–791.
Kopsco HL, Mather TN. Tick-Borne Disease Prevention Behaviors Among Participants in a Tick Surveillance System Compared with a Sample Of Master Gardeners. J Community Health. 2022;47(2):246–256.
Septfons A, Figoni J, Gautier A, et al. Increased awareness and knowledge of Lyme Borreliosis and tick bite prevention among the general population in France: 2016 and 2019 health barometer survey. BMC Public Health. 2021;21(1):1808.
Wozinska M, Toczylowski K, Lewandowski D, et al. Knowledge, Attitudes, and Behaviors Regarding Lyme Borreliosis Prevention in the Endemic Area of Northeastern Poland. Vaccines (Basel). 2022;10(12):2163.
Cuadera MKQ, Mader EM, Safi AG, et al. Knowledge, attitudes, and practices for tick bite prevention and tick control among residents of Long Island, New York, USA. Ticks Tick Borne Dis. 2023;14(3):102124.
Kullberg BJ, Vrijmoeth HD, van de Schoor F, et al. Lyme borreliosis: diagnosis and management. BMJ. 2020;369:m1041.
O’Connell. S. Lyme borreliosis: current issues in diagnosis and management. Curr Opin Infect Dis. 2010;23(3):231–5.
Crist SD, Kopsco H, Miller A, et al. Knowledge, attitudes, and practices of veterinary professionals towards ticks and tick-borne diseases in Illinois. One Health. 2022;14:100391.
Vasić A, Bjekić J, Veinović G, et al. Knowledge, Attitudes, and Practices on Tick-Borne Encephalitis Virus and Tick-Borne Diseases within Professionally Tick-Exposed Persons, Health Care Workers, and General Population in Serbia: A Questionnaire-Based Study. Int J Environ Res Public Health. 2022;19(2):867.
Beck A, Bjork J, Biggerstaff BJ, et al. Knowledge, attitudes, and behaviors regarding tick-borne disease prevention in Lyme disease-endemic areas of the Upper Midwest, United States. Ticks Tick Borne Dis. 2022;13(3):101925.
Richardson M, Khouja C, Sutcliffe K. Interventions to prevent Lyme disease in humans: A systematic review. Prev Med Rep. 2018;13:16–22. 10.1016/j.pmedr.2018.11.004.
Kianersi S, Luetke M, Wolfe CG, et al. Associations Between Personal Protective Measures and Self-Reported Tick-Borne Disease Diagnosis in Indiana Residents. J Community Health. 2020;45(4):739–750.
Eisen L. Personal protection measures to prevent tick bites in the United States: Knowledge gaps, challenges, and opportunities. Ticks Tick Borne Dis. 2022;13(4):101944.
Bayles BR, Evans G, Allan BF. Knowledge and prevention of tick-borne diseases vary across an urban-to-rural human land-use gradient. Ticks Tick Borne Dis. 2013;4(4):352–8.
De Keukeleire M, Robert A, Luyasu V, et al. Seroprevalence of Borrelia burgdorferi in Belgian forestry workers and associated risk factors. Parasit Vectors. 2018;11(1):277.
Černý J, Lynn G, Hrnková J, et al. Management Options for Ixodes ricinus-Associated Pathogens: A Review of Prevention Strategies. Int J Environ Res Public Health. 2020;17(6):1830.
Wójcik-Fatla A, Zając V, Sawczyn A, et al. Infections and mixed infections with the selected species of Borrelia burgdorferi sensu lato complex in Ixodes ricinus ticks collected in eastern Poland: a significant increase in the course of 5 years. Exp Appl Acarol. 2016;68(2):197–212.
Hoeve-Bakker BJA, van den Berg OE, Doppenberg HS, et al. Seroprevalence and Risk Factors of Lyme Borreliosis in The Netherlands: A Population-Based Cross-Sectional Study. Microorganisms. 2023;11(4):1081.
Burn L, Pilz A, Vyse A, et al. Seroprevalence of Lyme Borreliosis in Europe: Results from a Systematic Literature Review (2005–2020). Vector Borne Zoonotic Dis. 2023;23(4):195–220.
Paradowska-Stankiewicz I, Zbrzeźniak J, Skufca J, et al. A Retrospective Database Study of Lyme Borreliosis Incidence in Poland from 2015 to 2019: A Public Health Concern. Vector Borne Zoonotic Dis. 2023;23(4):247–255.
Acke S, Couvreur S, Bramer WM, et al. Global infectious disease risks associated with occupational exposure among non-healthcare workers: a systematic review of the literature. Occup Environ Med. 2022;79(1):63–71.
Stufano A, Iatta R, Sgroi G, et al. Seroprevalence of vector-borne pathogens in outdoor workers from southern Italy and associated occupational risk factors. Parasit Vectors. 2022;15(1):264.
Zając V, Pinkas J, Wójcik-Fatla A, et al. Prevalence of serological response to Borrelia burgdorferi in farmers from eastern and central Poland. Eur J Clin Microbiol Infect Dis. 201;36(3):437–446.
Markowicz M, Reiter M, Gamper J, et al. Persistent Anti-Borrelia IgM Antibodies without Lyme Borreliosis in the Clinical and Immunological Context. Microbiol Spectr. 2021;9(3):e0102021.
Jensen BB, Bruun MT, Jensen PM, et al. Evaluation of factors influencing tick bites and tick-borne infections: a longitudinal study. Parasit Vectors. 2021;14(1):289.
Dersch R, Sarnes A, Maul M, et al. Immunoblot reactivity at follow-up in treated patients with Lyme neuroborreliosis and healthy controls. Ticks Tick Borne Dis. 2019;10(1):166–169.
Kowalec M, Szewczyk T, Welc-Falęciak R, et al. Ticks and the city – are there any differences between city parks and natural forests in terms of tick abundance and prevalence of spirochaetes? Parasit Vectors. 2017;10(1):573.
Sormunen JJ, Kulha N, Klemola T, et al. Enhanced threat of tick-borne infections within cities? Assessing public health risks due to ticks in urban green spaces in Helsinki, Finland. Zoonoses Public Health. 2020;67(7):823–839.
Brzozowska M, Wierzba A, Śliwczyński A, et al. The problem of Lyme borreliosis infections in urban and rural residents in Poland, based on National Health Fund data. Ann Agric Environ Med. 2021;28(2):277–282.
Journals System - logo
Scroll to top