A systematic review of the effectiveness and utility of Lyme disease prevention measures in Canada, the United States, and Europe

Abstract

Abstract Background This systematic review aimed to assess the effectiveness of interventions which reduce human-tick encounters, prevent tick bites, and reduce the risk of Borrelia burgdorferi transmission, and to evaluate knowledge on the cost, environmental impact, social impact and acceptability, and public health impact of these interventions. Methods The search was conducted in Medline, Embase, Global Health, CAB Abstracts, Cochrane CENTRAL, Scopus, and Econlit for relevant literature in March 2022 and was updated in November 2024 and followed PRISMA guidelines for systematic reviews. Inclusion was applied at citation and full text, after which articles were assessed for risk of bias and data was extracted by two independent reviewers. Studies were summarized by intervention type (landscape management, host animal parasitism and movement, chemical/natural/botanical applications, personal protection) and a multi-study synthesis of tick suppression effects was conducted for interventions that reported the density of infected nymphs as the primary outcome. Results One hundred and twenty-seven studies published between 1977 and 2024 were included in this systematic review. Most studies (n = 62) were classified as host-targeted interventions. Twenty-five studies were included in the multi-study synthesis of tick suppression effects, which suggested that chemical tick control methods are the most effective and consistent intervention type with 93.8% mean suppression of questing nymphs. Conclusion While some strategies such as chemical acaricides were shown to have greater effectiveness, factors such as social acceptability and resistance, environmental impact, cost, and feasibility should be considered when selecting the most appropriate intervention to maximize the utility of the intervention.