Quality over quantity in active tick surveillance: Sentinel surveillance outperforms risk-based surveillance for tracking tick-borne disease emergence in southern Canada.

Camille Guillot, Catherine Bouchard, Kayla Buhler, Roxane Pelletier, François Milord, Patrick Leighton
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Abstract

Background: Lyme disease (LD) emerged in southern Québec at the start of the century, with many municipalities now endemic. A coordinated active surveillance programme has been in place in the province of Québec since 2014, including a limited number of sentinel field sites resampled each year and a larger set of accessory field sites that change yearly according to the LD surveillance signal. We aimed to evaluate whether a sentinel approach to active surveillance was more representative of LD risk to human populations, compared to risk-based surveillance.

Methods: We compared enzootic hazard measures (average nymph densities) from sentinel and accessory sites with LD risk (number of human LD cases) across the study area between 2015 and 2019 using local bivariate Moran's I analysis.

Results: Hazard measures from sentinel sites captured spatial risk significantly better than data from accessory sites (χ2=20.473, p<0.001). In addition, sentinel sites successfully tracked the interannual trend in LD case numbers, whereas accessory sites showed no association despite the larger sample size.

Conclusion: Where surveillance aims to document changes in tick-borne disease risk over time and space, we suggest that repeated sampling of carefully selected field sites may be most effective, while risk-based surveillance may be more usefully applied to confirm the presence of emerging disease risk in a specific region of interest or to identify suitable sites for long-term monitoring as LD and other tick-borne diseases continue to emerge.

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蜱虫主动监测的质量重于数量:在跟踪加拿大南部出现的蜱传疾病方面,哨点监测优于基于风险的监测。
背景:莱姆病(LD)于本世纪初在魁北克省南部出现,现在许多城市都有流行。自 2014 年以来,魁北克省一直在实施一项协调的主动监测计划,其中包括每年重新采样的数量有限的哨点现场,以及根据 LD 监测信号逐年变化的一组更大的附属现场。我们旨在评估,与基于风险的监测相比,哨点主动监测方法是否更能代表LD对人类的风险:我们使用局部双变量莫兰 I 分析法,比较了 2015 年至 2019 年期间哨点和附属地点的流行病危害测量值(平均若虫密度)与整个研究区域的 LD 风险(人类 LD 病例数):结果:来自哨点的危险度量数据对空间风险的捕捉效果明显优于来自附属点的数据(χ2=20.473,p结论:如果监测的目的是记录蜱传疾病风险在时间和空间上的变化,我们建议对精心挑选的野外地点进行重复采样可能最有效,而基于风险的监测可能更适用于确认特定相关区域是否存在新出现的疾病风险,或在 LD 和其他蜱传疾病不断出现时确定适合进行长期监测的地点。
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