title: Factors Associated with Tick Bite Preventive Practices among Farmworkers in Malaysia.
abstract: BACKGROUND
  Farmworkers are at high-risk for tick bites, which potentially transmit various tick-borne diseases. Previous studies show that personal prevention against tick bites is key, and certain factors namely, knowledge, experience of tick bites, and health beliefs influence compliance with tick bites preventive behaviour. This study aimed to assess these factors and their associations with tick bite preventive practices among Malaysian farmworkers.
  
  
  METHODS
  A total of eight cattle, goat and sheep farms in six states in Peninsular Malaysia participated in a cross-sectional survey between August and October 2013.
  
  
  RESULTS
  A total of 151 (72.2%) out of 209 farmworkers answered the questionnaire. More than half of the farmworkers (n = 91) reported an experience of tick bites. Farms with monthly acaricide treatment had significantly (P<0.05) a low report of tick bites. Tick bite exposure rates did not differ significantly among field workers and administrative workers. The mean total knowledge score of ticks for the overall farmworkers was 13.6 (SD±3.2) from 20. The mean total tick bite preventive practices score for all farmworkers was 8.3 (SD±3.1) from 15. Fixed effect model showed the effects of four factors on tick bite prevention: (1) farms, (2) job categories (administrative workers vs. field workers), (3) perceived severity of tick bites, and (4) perceived barriers to tick bite prevention.
  
  
  CONCLUSIONS
  A high proportion of farmworkers, including administrative workers, reported an experience of tick bites. The effectiveness of monthly acaricide treatment was declared by low reports of tick bites on these farms. Tick bite preventive practices were insufficient, particularly in certain farms and for administrative workers. Our findings emphasise the need to have education programmes for all farmworkers and targeting farms with low prevention practices. Education and health programmes should increase the perception of the risk of tick bites and remove perceived barriers of tick bite prevention.
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Masoumeh
authors.identifier: http://orcid.org/0000-0001-5614-620X
authors.initials: M
authors.lastname: Ghane Kisomi
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.|Julius Centre University of Malaya (JCUM), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Li Ping
authors.initials: LP
authors.lastname: Wong
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Sun Tee
authors.initials: ST
authors.lastname: Tay
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.|Julius Centre University of Malaya (JCUM), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Awang
authors.initials: A
authors.lastname: Bulgiba
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Keivan
authors.initials: K
authors.lastname: Zandi
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Kai Ling
authors.initials: KL
authors.lastname: Kho
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Fui Xian
authors.initials: FX
authors.lastname: Koh
authors.affiliation: Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, University Malaysia Kelantan, Kelantan, Malaysia.
authors.forename: Bee Lee
authors.initials: BL
authors.lastname: Ong
authors.affiliation: Department of Veterinary Services, Ministry of Agriculture and Agro-Based Industry Malaysia, Federal Government Administrative Centre, Putrajaya, Malaysia.
authors.forename: Tariq
authors.initials: T
authors.lastname: Jaafar
authors.affiliation: Department of Veterinary Services, Ministry of Agriculture and Agro-Based Industry Malaysia, Federal Government Administrative Centre, Putrajaya, Malaysia.
authors.forename: Quaza Nizamuddin
authors.initials: QN
authors.lastname: Hassan Nizam
mesh_terms: D000328:Adult; D000818:Animals; D003430:Cross-Sectional Studies; D015981:Epidemiologic Factors; D000067565:Farmers; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062486:Public Health Surveillance; D012959:Socioeconomic Factors; D064927:Tick Bites / Q000517:prevention & control*; D017282:Tick-Borne Diseases / Q000517:prevention & control* / Q000628:therapy / Q000635:transmission; D055815:Young Adult