{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T10:06:10Z","timestamp":1771409170415,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Although tick\u2010borne disease (TBD) incidence has increased in the United States (U.S.) in the past decade, new evidence suggests that notifiable diseases surveillance records may not accurately reflect the true magnitude of TBD diagnoses. Furthermore, while regional electronic health records (EHR) are readily accessible their potential use as a more stable and consistent source of TBD diagnoses data has remained largely unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      In this study, we used EHR from a database of more than 100 hospitals, healthcare networks, and insurance providers in Indiana, U.S., to better understand incidence, spatio\u2010temporal and demographic distribution of TBD Diagnoses from 2009\u20132018. Our results revealed that in Indiana, from 2009 to 2018, there were 5173 unique TBD Diagnoses across three diagnoses categories: Lyme disease (72.5%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093751), Rickettsioses (12.0%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009623) and Other TBD Diagnoses (15.4%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009799). Using EHR, the average yearly Lyme disease diagnoses was more than double the cases obtained using notifiable disease surveillance data for the same period. Patients with a TBD Diagnoses were generally older (ages 45\u201359) and less racially diverse (96.3% white). Rickettsiosis diagnoses were reported more among male patients (55.2%), while Lyme disease diagnoses were higher among female patients (57.1%). Temporal data illustrated higher frequencies of diagnoses from May to July. Hot spot analysis identified a Lyme disease hot spot in northwest Indiana, while hotspots of Rickettsiosis and Other TBD Diagnoses category were identified in southwest Indiana. Extrapolated to the Indiana population, chi\u2010squared (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) tests of independence revealed that the observed distribution of TBD diagnoses in our data was significantly different from the expected distribution in the Indiana population\u2010based race, gender and age groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study findings demonstrate that in Indiana, EHR provide a stable data source for elucidating TBD disease burden and for monitoring spatio\u2010temporal trends in TBD diagnoses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/zph.13128","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T01:34:51Z","timestamp":1711589691000},"page":"653-662","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Spatio\u2010temporal patterns of tick\u2010borne disease diagnoses in Indiana,\n                    <scp>USA<\/scp>\n                    (2009\u20132018)"],"prefix":"10.1111","volume":"71","author":[{"given":"Oghenekaro","family":"Omodior","sequence":"first","affiliation":[{"name":"Health Affairs Institute, West Virginia University  Morgantown West Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina R.","family":"Anderson","sequence":"additional","affiliation":[{"name":"School of Public Health Indiana University Bloomington  Bloomington Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Blekking","sequence":"additional","affiliation":[{"name":"Department of Geography, College of Arts &amp; Sciences Indiana University Bloomington  Bloomington Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaukis","family":"Nicholas","sequence":"additional","affiliation":[{"name":"Fay W. Boozman College of Public Health University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2009.80.72"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph120910536"},{"key":"e_1_2_9_4_1","first-page":"54","article-title":"Demographic differences within race\/ethnicity group constraints to outdoor recreation participation","volume":"29","author":"Bustam T. D.","year":"2011","journal-title":"Journal of Park and Recreation Administration"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2604.191629"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ilar\/ilx005"},{"key":"e_1_2_9_7_1","volume-title":"2017 Indiana trails study","author":"Eppley Institute","year":"2018"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-012370466-5.50010-8"},{"key":"e_1_2_9_9_1","unstructured":"Ginsberg H. S. &Faulde M.(2008).Ticks."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12810"},{"key":"e_1_2_9_11_1","unstructured":"Indiana Department Of Health. (2024a).Lyme Disease: Data and Statistics[Online]. Available:https:\/\/www.in.gov\/health\/idepd\/zoonotic\u2010and\u2010vectorborne\u2010epidemiology\u2010entomology\/maps\u2010and\u2010statistics\/lyme\u2010disease\u2010data\u2010and\u2010statistics\/[Accessed February 18 2024]."},{"key":"e_1_2_9_12_1","unstructured":"Indiana department of health. (2024b).Spotted Fever Rickettsiosis: Data and Statistics[Online]. Available:https:\/\/www.in.gov\/health\/idepd\/zoonotic\u2010and\u2010vectorborne\u2010epidemiology\u2010entomology\/maps\u2010and\u2010statistics\/rocky\u2010mountain\u2010spotted\u2010fever\u2010data\u2010and\u2010statistics\/[Accessed February 20 2024]."},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jme\/tjab038"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2109.150417"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2019.0159"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2019.0159"},{"key":"e_1_2_9_17_1","volume-title":"Relationship between tick activity, tick\u2010borne diseases, cognitive and affective risk assessment in peri\u2010domestic Areas","author":"Omodior O.","year":"2020"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2021.101684"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.25177\/JESES.5.3.RA.10668"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-9062.316271"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-019-00691-0"},{"issue":"2","key":"e_1_2_9_22_1","article-title":"Efficacy of the theory of planned behavior in predicting the intention to engage in tick\u2010borne disease personal protective behavior amongst visitors to an outdoor recreation center","author":"Omodior O.","year":"2015","journal-title":"Journal of Park and Recreation Administration"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17145105"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10493-014-9798-7"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6622a1"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2702.202728"},{"key":"e_1_2_9_27_1","unstructured":"Statsindiana. (2020).Population[Online]. Available:https:\/\/www.stats.indiana.edu\/topic\/population.asp[Accessed]."},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-2286-0"},{"key":"e_1_2_9_29_1","volume-title":"Lesson 5: Public health surveillance appendix E","author":"U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION","year":"2012"},{"key":"e_1_2_9_30_1","unstructured":"U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION. (2021).Tickborne disease surveillance data summary[Online]. Available:https:\/\/www.cdc.gov\/ticks\/data\u2010summary\/index.html[Accessed June 2 2021]."},{"key":"e_1_2_9_31_1","unstructured":"U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION. (2022).Understanding Lyme and Other Tickborne Diseases[Online]. Available:https:\/\/www.cdc.gov\/ncezid\/dvbd\/media\/lyme\u2010tickborne\u2010diseases\u2010increasing.html#:~:text=Biography for%20Lyme%20disease%20has%20tripled[Accessed February 20 2024]."},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/jme\/tjab155"}],"container-title":["Zoonoses and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/zph.13128","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/zph.13128","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/zph.13128","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T09:11:34Z","timestamp":1771405894000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/zph.13128"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,27]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/zph.13128"],"URL":"https:\/\/doi.org\/10.1111\/zph.13128","archive":["Portico"],"relation":{},"ISSN":["1863-1959","1863-2378"],"issn-type":[{"value":"1863-1959","type":"print"},{"value":"1863-2378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,27]]},"assertion":[{"value":"2024-01-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}