Knowledge, Attitudes, and Practices Regarding Tick-Borne Diseases Among People Living in Niigata Prefecture, Japan

Background: A recent comprehensive study identified Niigata prefecture, Japan, as an emerging endemic area for tick-borne diseases (TBDs). This study examined the knowledge, attitude, and practices (KAP) of people living in Niigata prefecture regarding TBDs and preventive strategies. Methods: The KAP was assessed using a questionnaire consisted of 17 items. Statistical tests such as student’s t-test, chi-square test, and multiple logistic regression were performed using SPSS version 27. Results: In total, 186 responses were received. Among the respondents, 130 (69·9%) were men, and the mean age was 51.1 (14·3). Nine (4·8%) respondents reported having experienced tick bites. Internet and television were the primary sources of information. Of the respondents, 44 (44·4%) knew about both scrub typhus and severe fever with thrombocytopenia syndrome, while 156 (83·9%) and 71 (38·2%) recognized limiting skin exposure and use of insect repellents as preventive measures, respectively. The attitudes towards TBDs: being worried about tick bites (p=0·018) and interested in preventing TBDs (p=0·001), were significantly higher among women than men. About 75% of the respondents reported taking preventive measures against tick bites, and limiting skin exposure was the most frequently applied method (69·9%). Insect repellents were used by 58 (31·2%) respondents. Age (p=0·049), being worried about tick bites (p=0·046), and knowledge of ticks score (p=0·024) were the significant independent predictors of practicing countermeasures. Interpretation: We identified gaps in knowledge and practices regarding TBDs. Public health interventions should be implemented to improve public awareness of TBDs. Funding Statement: This work was supported by JSPS KAKENHI, Japan [Grant number 16K00569]. Declaration of Interests: The authors have no relevant conflicts of interest to declare. Ethics Approval Statement: Ethical clearance was obtained from the Ethical Review Committee on research involving human subjects in Niigata University, Japan (No. 2017-0140). Each participant received an explanation about the study and the opt-out to respond/ return the questionnaire. The return of the completed questionnaire was considered as the consent.