Klein J D, Eppes S C, Hunt P
Department of Pediatrics, Jefferson Medical College, Wilmington, Delaware, USA.
Clin Pediatr (Phila). 1996 Jul;35(7):359-63. doi: 10.1177/000992289603500705.
Risk factors for Lyme disease and/or infection with Borrelia burgdorferi in children are not defined. A case-control study was performed using Lyme disease patients from our Lyme Clinic population. Age- and sex-matched controls from the same neighborhood were identified by the Lyme patients' families. A site visit was made to each case/control neighborhood. Twenty-four environmental variables, especially the ecologic characteristics of the home environment were examined. Forty-five items were surveyed by parent questionnaire, including certain "high-risk" activities and behaviors, whether ticks or certain animals were present on the property, and whether antitick measures were used. Control subjects had serologic assays for antibodies to B. burgdorferi. Forty-four Lyme disease patients and 44 well-matched control subjects participated; 2 controls were seropositive. Significant associations with Lyme disease were found for deer ticks in the home environment, ground cover containing moist humus, and leaf litter in the yard. Among the 45 items related to life-style, there was no correlation with Lyme disease for the use of any antitick measures or for any childhood activities; in fact, an inverse correlation was observed for camping and fishing. We conclude that conditions in the immediate home environment, including certain ecologic factors that favor the presence of Ixodes ticks, are associated with an increased risk for Lyme disease in children.
儿童莱姆病和/或感染伯氏疏螺旋体的风险因素尚不明确。我们利用莱姆病诊所的患者开展了一项病例对照研究。莱姆病患者的家人从同一社区中确定了年龄和性别匹配的对照。对每个病例/对照社区进行了实地考察。研究了24个环境变量，尤其是家庭环境的生态特征。通过家长问卷对45个项目进行了调查，包括某些“高风险”活动和行为、房产内是否有蜱虫或某些动物，以及是否采取了防蜱措施。对照对象接受了针对伯氏疏螺旋体抗体的血清学检测。44名莱姆病患者和44名匹配良好的对照对象参与了研究；2名对照对象血清学呈阳性。研究发现，家庭环境中的鹿蜱、含有潮湿腐殖质的地被植物以及院子里的落叶与莱姆病存在显著关联。在与生活方式相关的45个项目中，任何防蜱措施的使用或任何儿童活动与莱姆病均无相关性；事实上，露营和钓鱼呈现出负相关。我们得出结论，家庭直接环境中的条件，包括某些有利于硬蜱生存的生态因素，与儿童莱姆病风险增加有关。
