title: Urban and rural risks of Lyme disease in the Scottish Highlands.
abstract: BACKGROUND
  This paper investigates the pattern of Lyme disease testing and infection within the Highland region of Scotland.
  
  
  METHODS
  Data from all Highland samples tested during 2004-2006 were analysed according to result and patient's residence in relation to the eight fold Scottish Executive's urban/rural classification, and distance from woodland.
  
  
  RESULTS
  In total, 1602 patients were tested for Lyme disease, 0.71% of the Highland population. From these, 104 (6.5%) were seropositive. There were more patients tested, and seropositive patients from rural than urban locations, 1113 vs 489, and 79 vs 25 respectively. There were also significantly more seropositive patients per patients tested from rural locations (chi2, p<0.0001). The number of patients tested and seropositive patients increased as the rural areas become more remote. The likelihood of being tested for Lyme disease also increased as the distance between a patient's residence and woodland decreased. The relative risk of being tested elevated by 74% for those patients living within 200 metres of woodland.
  
  
  CONCLUSIONS
  Those living in the most rural areas of Highland and those living closest to woodland have an increased risk of being tested and having Lyme disease.
authors.affiliation: National Lyme Disease Testing Laboratory, Microbiology Department, Raigmore Hospital, Old Perth Road, Inverness, IV2 3UJ.
authors.forename: S
authors.initials: S
authors.lastname: Mavin
authors.forename: P C
authors.initials: PC
authors.lastname: Hopkins
authors.forename: A
authors.initials: A
authors.lastname: MacLennan
authors.forename: A W L
authors.initials: AW
authors.lastname: Joss
authors.forename: D O
authors.initials: DO
authors.lastname: Ho-Yen
mesh_terms: D000818:Animals; D025065:Borrelia burgdorferi; D017753:Ecosystem; D006801:Humans; D018884:Ixodes; D008193:Lyme Disease / Q000175:diagnosis / Q000453:epidemiology*; D012111:Residence Characteristics; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012606:Scotland / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*; D055814:Wilderness