title: Lyme disease: Knowledge and practices of family practitioners in southern Quebec.
abstract: BACKGROUND
  Public health authorities in Quebec have responded to the progressive emergence of Lyme disease (LD) with surveillance activities and education for family physicians (FPs) who are key actors in both vigilance and case management.
  
  
  OBJECTIVE
  To describe FPs' clinical experience with LD, their degree of knowledge, and their practices in two areas, one with known infected tick populations (Montérégie) and one without (regions nearby Montérégie).
  
  
  METHODS
  In the present descriptive cross-sectional study, FPs were recruited during educational sessions. They were asked to complete a questionnaire assessing their clinical experience with Lyme disease, their knowledge of signs and symptoms of LD, and their familiarity with accepted guidelines for diagnosing and treating LD in two clinical scenarios (tick bite and erythema migrans).
  
  
  RESULTS
  A total of 201 FPs participated, mostly from Montérégie (n=151). Overall, results revealed a moderate lack of knowledge and suboptimal practices rather than systematically insufficient knowledge or inadequate practices. A majority of participants agreed to more education on LD. As expected, FPs from Montérégie had a higher clinical experience with tick bites (57% versus 25%), better knowledge of LD endemic areas in Canada and erythema migrans characteristics, and better management of erythema migrans (72% versus 50%).
  
  
  CONCLUSIONS
  The present study documented the inappropriate intention to order serology tests for tick bites and the unjustified intention to use tick analysis for diagnostic purposes. Such practices should be discouraged because they are unnecessary and overuse collective laboratory and medical resources. In addition, public health authorities must pursue their education efforts regarding FPs to optimize case management.
authors.affiliation: Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, St Hyacinthe; ; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Montréal;
authors.forename: Cécile
authors.initials: C
authors.lastname: Ferrouillet
authors.affiliation: Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Montréal; ; Direction de santé publique, Agence de la santé et des services sociaux de la Montérégie, Longueuil;
authors.forename: François
authors.initials: F
authors.lastname: Milord
authors.affiliation: Direction de santé publique, Agence de la santé et des services sociaux de la Montérégie, Longueuil;
authors.forename: Louise
authors.initials: L
authors.lastname: Lambert
authors.affiliation: Service de microbiologie-infectiologie, CSSS Richelieu-Yamaska;
authors.forename: Anne
authors.initials: A
authors.lastname: Vibien
authors.affiliation: Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, St Hyacinthe; ; Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, St Hyacinthe, Québec.
authors.forename: André
authors.initials: A
authors.lastname: Ravel
keywords: Health knowledge, attitudes, practice; Lyme disease; Quebec