Assessing knowledge and preventive behavior of BC hikers towards Lyme disease
Authors: Nategh Goodraz , Chen Dale , Health BCIT School of Health Sciences Environmental 
Published: February 2022

BackgroundIn Canada, recent data shows that Lyme diseases (LD) have increased in many different regions of the country. British Columbia (BC), with its natural beauty and suitable terrain for outdoor activities, has drawn thousands of hikers to the established hiking trails, as well as off–trail wilderness. Consequently, more people are expected to be exposed to Lyme disease every year. For better understanding of the risk, study of their knowledge and awareness, and also their preventative behavior against Lyme disease is necessary. The purpose of our study is to evaluate hiker awareness about LD and assess type and frequency of preventive measures they take against the disease.MethodsA self-administered electronic survey was created and disseminated online among hikers in British Columbia, Canada. The online survey distributed via the social platform, Reddit, and took approximately five minutes to complete. The results were collected and organized in Microsoft Excel and analyzed with NCSS statistical software (NCSS, 2021).ResultsThe results of this study indicated that general awareness of LD among hikers in British Columbia is high. Ninety-eight percent of participants in the study have heard about the LD before the study was conducted. Hikers are generally aware of the prevalence of the disease (83%) in BC and know that ticks are problematic for them (74%). Majority of hikers (92%) have taken at least one measure to protect themselves against the disease. Avoiding tall grasses and bushwalking while hiking was the most popular method as 46% of the hikers frequently (more than half the time) took this measure. In contrast, wearing protective cloths or tucking pants into socks were the least frequent methods taken by them. Also, 68% of the hikers never used chemical insect repellent to deter ticks. This result suggests that avoiding ticks and tick bites by avoiding grassy areas, where ticks might be present, is the preferred method over the usage of chemical insect repellants, or physical barriers against tick bites such as wearing protective cloths or tucking pants into the socks; however, further data is needed to precisely conclude this result.Our study found that there are no significant statistical associations between hiker's knowledge and their level of education (P= 0.77), hiker's education level and preventive method taken (P=0.91), level of hiking experience and preventive method taken (P=0.86) or gender of the hikers and preventive methods taken (P=0.068) against the Lyme disease.ConclusionsAs Lyme disease has been recognized as a potentially increasing infectious disease in British Columbia, assessment of hiker's knowledge and preventive behavior towards LD through an online survey concluded that BC hikers have high level of awareness about the disease, and they protect themselves against the tick bites.

As predictive models show that climate change and warmer weather cause an expansion in tick habitat in North America, probability of hikers being exposed to ticks is higher. As the risk increases, LD prevention campaigns could be designed considering what prevention methods are the most popular; and more effective or innovative prevention methods could be introduced to the population. Health authorities may introduce LD prevention initiatives and educational plans that are adaptable and suitable to the geographical region based on prevalence of the disease. Similarly hiking groups may educate their new members regarding the disease, how to prevent it and what methods are suitable based on the region they are active in.