Department of Epidemiology, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland.
PLoS One. 2012;7(9):e45511. doi: 10.1371/journal.pone.0045511. Epub 2012 Sep 19.
Tick-borne encephalitis (TBE) is endemic to Europe and medically highly significant. This study, focused on Poland, investigated individual risk factors for TBE symptomatic infection.
In a nation-wide population-based case-control study, of the 351 TBE cases reported to local health departments in Poland in 2009, 178 were included in the analysis. For controls, of 2704 subjects (matched to cases by age, sex, district of residence) selected at random from the national population register, two were interviewed for each case and a total of 327 were suitable for the analysis. Questionnaires yielded information on potential exposure to ticks during the six weeks (maximum incubation period) preceding disease onset in each case. Independent associations between disease and socio-economic factors and occupational or recreational exposure were assessed by conditional logistic regression, stratified according to residence in known endemic and non-endemic areas. Adjusted population attributable fractions (PAF) were computed for significant variables. In endemic areas, highest TBE risk was associated with spending ≥10 hours/week in mixed forests and harvesting forest foods (adjusted odds ratio 19.19 [95% CI: 1.72-214.32]; PAF 0.127 [0.064-0.193]), being unemployed (11.51 [2.84-46.59]; 0.109 [0.046-0.174]), or employed as a forester (8.96 [1.58-50.77]; 0.053 [0.011-0.100]) or non-specialized worker (5.39 [2.21-13.16]; 0.202 [0.090-0.282]). Other activities (swimming, camping and travel to non-endemic regions) reduced risk. Outside TBE endemic areas, risk was greater for those who spent ≥10 hours/week on recreation in mixed forests (7.18 [1.90-27.08]; 0.191 [0.065-0.304]) and visited known TBE endemic areas (4.65 [0.59-36.50]; 0.058 [-0.007-0.144]), while travel to other non-endemic areas reduced risk.
These socio-economic factors and associated human activities identified as risk factors for symptomatic TBE in Poland are consistent with results from previous correlational studies across eastern Europe, and allow public health interventions to be targeted at particularly vulnerable sections of the population.
蜱传脑炎（TBE）在欧洲流行，具有重要的医学意义。本研究聚焦于波兰，旨在调查 TBE 症状感染的个体风险因素。
在一项全国范围内基于人群的病例对照研究中，2009 年波兰地方卫生部门报告的 351 例 TBE 病例中，有 178 例纳入分析。对于对照组，从全国人口登记处随机选择 2704 名（与病例按年龄、性别、居住地区匹配）受试者，每例病例匹配 2 名对照，共有 327 名适合分析。在每个病例的疾病发病前 6 周（最大潜伏期），通过问卷获取潜在暴露于蜱的信息。采用条件逻辑回归，根据已知疫区和非疫区的居住情况，对疾病与社会经济因素以及职业或娱乐暴露之间的独立关联进行评估。对于有统计学意义的变量，计算了调整后的人群归因分数（PAF）。在疫区，与 TBE 风险最高相关的因素包括每周在混合林度过≥10 小时（调整后的优势比 19.19 [95%CI：1.72-214.32]；PAF 0.127 [0.064-0.193]）、从事无业（11.51 [2.84-46.59]；0.109 [0.046-0.174]）、林务员（8.96 [1.58-50.77]；0.053 [0.011-0.100]）或非专业工人（5.39 [2.21-13.16]；0.202 [0.090-0.282]），或从事农业工作。其他活动（游泳、露营和前往非疫区）则降低了风险。在 TBE 非疫区，每周在混合林进行≥10 小时娱乐活动（7.18 [1.90-27.08]；PAF 0.191 [0.065-0.304]）或前往已知 TBE 疫区（4.65 [0.59-36.50]；PAF 0.058 [-0.007-0.144]）的风险更高，而前往其他非疫区则降低了风险。
这些在波兰被确定为 TBE 症状感染的风险因素的社会经济因素和相关人类活动与东欧之前的相关性研究结果一致，这使得可以针对特定人群开展公共卫生干预措施。
