Knowledge, Attitudes, and Practices on Tick-Borne Human Diseases and Tick-Borne Encephalitis Vaccine among Farmers from North-Eastern Italy (2017).

Objectives : Tick-borne diseases (T-BD) represent a potential health threat for outdoor workers in endemic areas, such as the Autonomous Province of Trento (APT). We conducted a questionnaire-based survey to assess T-BD knowledge, attitudes, and preventive practices among APT farmers, specifically focusing on the use of protective habits and the uptake of the tick-borne encephalitis (TBE) vaccine. Methods : A convenience sample of 106 farmers (all males, mean age 47.3 ± 13.6 years) attending pesticide training courses (12/2016-03/2017) completed the anonymous survey. Binary regression analysis, calculations of multivariate odds ratios (mOR) and 95% confidence intervals were used to assess knowledge, attitudes, and risk perceptions as predictors of preventive measures. Results : Though general understanding of T-BD was fairly low, the majority of the participants perceived TBE infection as a frequent (73.6%) and severe disease (61.3%). Overall, 43.3% of participants knew a TBE vaccine was available, and 24.5% had been vaccinated. Protective habits were reported by 53.8% of respondents, with self-checks for tick bites particularly low at 2.8% of participants. Better knowledge of T-BD and favorable attitudes toward vaccinations were associated with TBE immunization (mOR 4.708; 95%CI 1.273-17.409 and mOR 3.555; 95%CI 1.175-10.760, respectively), while previous history of tick bite and any interaction with T-BD significantly predicted adherence to protective measures (mOR 4.458; 95%CI 1.808-10.991, and mOR 9.433; 95%CI 1.127-78.973, respectively). Conclusions : Adherence to preventive measures (TBE vaccine) and protective habits was unsatisfactory in our sampled group, being a possible consequence of significant knowledge gaps. Public health communication on T-BD in farmers should, therefore, target understanding of health issues and appropriate preventive measures.