Interventions to prevent Lyme disease in humans: a systematic review

1. Richardson , C. Khouja , K. Sutcliffe

Published in 2019

16 studies included evaluated 5 types of prevention interventions.

Types of interventions examined:

Personal protection (n=4)- low quality

• Tick repellants on skin or clothing was associated with a lower rate of LD
• Effects were mixed for association between tick checks and incidence of LD
• Bathing within 2h of being outside has a possible association with lower incidence of LD
• Permethrin-treated battle dress uniform and citriodiol insect repellent may reduce number of ticks crawling or bites

Domestic strategies (n=3)- low quality

• Having a fence, stone wall, trimming hanging branches, having a dry barrier, spraying the yard and killing other pests may be associated with lower incidence of LD.
• Mowing lawn frequently and having a vegetable garden, bird feeder, words near property, log pile and clearing leaves may be associated with higher incidence of LD
• Spraying lawn reduced frequency of ticks crawling or attached
• Effects were mixed for spraying lawn for actual incidence of LD

Education (n=6)- low quality

• Education via leaflet, video, mail, presentation and live show may increase adults’ general knowledge, efficacy and behavioral intention of taking preventative measures.
• Education via postal information may increase protection behavior
• Live show education may reduce incidence
• Classroom education may increase children’s knowledge about LD and tick check frequency
• Conclusion: education may be effective, but there is still uncertainty about which form of education leads to modified behavior in a way that LD incidence is actually decreased.

Vaccination (n=3)- low and high quality

• Two RCTs: Multivalent vaccine may produce an immune response that helps prevent LD and is well tolerated. The vaccines do produce an immune response, but more long term evidence is needed to see long-term effects
• Low quality: there is reduced use of preventative behavior with LYMErix vaccine

Deer-targeted programs (n=2)- low quality

• Deer removal may reduce tick abundance compared with control
• Effects were mixed for impact of deer removal on incidence of LD
• Effects were mixed for impact of acaricide, applies to deer’s ears and head on incidence of LD

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