{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T18:56:54Z","timestamp":1784055414348,"version":"3.55.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T00:00:00Z","timestamp":1691452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018664","name":"Mongolian National University of Medical Sciences","doi-asserted-by":"publisher","award":["2013\/04.21"],"award-info":[{"award-number":["2013\/04.21"]}],"id":[{"id":"10.13039\/100018664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p><jats:italic>Borrelia burgdorferi<\/jats:italic> sensu lato and <jats:italic>Rickettsia<\/jats:italic> spp. are worldwide causes of tick-borne infections. We aimed to estimate the seroprevalence of immunoglobulin G (IgG) antibodies against different tick-borne diseases (TBDs) and determine risk factors among Mongolians from 2016 to 2020. Blood samples were obtained from voluntary participants with a history of suspected tick bite who visited our hospital, and IgG antibodies against <jats:italic>Rickettsia<\/jats:italic> and <jats:italic>Borrelia<\/jats:italic> were detected using enzyme-linked immunosorbent assay (ELISA). The IgG antibody seropositivity rate against <jats:italic>Rickettsia<\/jats:italic> was 21.8% (1032\/4724), while 3.4% (162\/4724) of participants tested positive for serum IgG antibodies against <jats:italic>Borrelia<\/jats:italic> by ELISA.Binary logistic regression analysis was performed to evaluate risk factors for tick-borne rickettsiosis (TBR) and tick-borne borreliosis (TBB) using IgG serum sample. Age, occupation, and residence were significantly associated with these diseases; however, sex did not show any significant association. Seroprevalence was significantly higher among herders (40.6%, 95% confidence interval [CI]: 35.5\u201345.8; odds ratio [OR] 0.61; <jats:italic>P<\/jats:italic> &lt; 0.001) and students (32.8%, 95% CI: 30.2\u201335.4; OR 0.75; <jats:italic>P<\/jats:italic> &lt; 0.001) than among individuals with other occupations. The 25\u201329 age group had a slightly higher seroprevalence (35.1%, 95% CI: 28.1\u201342.6; OR 0.61; <jats:italic>P<\/jats:italic> &lt; 0.006) than those in other age groups. Province was a stronger predictor of TBR than occupation and age group. In univariate subgroup analysis by age group, occupation, and residence were significantly associated with TBR seroprevalence, whereas age and province were associated with TBB seroprevalence. Thus, risk factors for TBD include residence, occupation, and age group. This study was conducted using samples from all Mongolian provinces and the capital city, and the risk factors and prevalence of <jats:italic>Rickettsia<\/jats:italic> and <jats:italic>Borrelia<\/jats:italic>are highlighted.<\/jats:p>","DOI":"10.1371\/journal.pone.0289274","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T17:28:51Z","timestamp":1691515731000},"page":"e0289274","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Seroprevalence and risk factors of Borrelia burgdorferi sensu lato and Rickettsia species infection in humans in Mongolia, 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Lkhagvatseren","year":"2019","journal-title":"Zoonoses and Public Health,"},{"key":"pone.0289274.ref004","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.actatropica.2017.10.015","article-title":"Estimated seroprevalence of Anaplasma spp. And spotted fever group Rickettsia exposure among herders and livestock in Mongolia","volume":"177","author":"ME von Fricken","year":"2018","journal-title":"Acta Tropica"},{"issue":"40","key":"pone.0289274.ref005","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ijmm.2006.01.031","article-title":"Serological evidence for tick-borne encephalitis, borreliosis, and human granulocytic anaplasmosis in Mongolia","volume":"296","author":"G Walder","year":"2006","journal-title":"International Journal of Medical Microbiology: IJMM"},{"issue":"3","key":"pone.0289274.ref006","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s10096-016-2813-7","article-title":"Prevalence of serological response to Borrelia burgdorferi in farmers from eastern and central Poland","volume":"36","author":"V Zaj\u0105c","year":"2017","journal-title":"European Journal of Clinical Microbiology & Infectious Diseases: Official Publication of the European Society of Clinical Microbiology"},{"issue":"140","key":"pone.0289274.ref007","article-title":"The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: A systematic review and meta-analysis.","volume":"16","author":"MM Leeflang","year":"2016","journal-title":"BMC Infectious Diseases,"},{"issue":"3","key":"pone.0289274.ref008","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s10096-012-1742-3","article-title":"Seroreactivity for spotted fever rickettsiae and co-infections with other tick-borne agents among habitants in central and southern Sweden","volume":"32","author":"A Lindblom","year":"2013","journal-title":"European Journal of Clinical Microbiology & Infectious Diseases: Official Publication of the European Society of 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Laboratory support for the diagnosis of Lyme borreliosis: a position paper of ESGBOR, the ESCMID study group for Lyme borreliosis","volume":"24","author":"RB Dessau","year":"2018","journal-title":"Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases"},{"issue":"6","key":"pone.0289274.ref012","doi-asserted-by":"crossref","first-page":"e007744","DOI":"10.1136\/bmjgh-2021-007744","article-title":"Global seroprevalence and sociodemographic characteristics of Borrelia burgdorferi sensu lato in human populations: A systematic review and meta-analysis","volume":"7","author":"Y Dong","year":"2022","journal-title":"BMJ Global Health"},{"issue":"4","key":"pone.0289274.ref013","doi-asserted-by":"crossref","first-page":"804","DOI":"10.3201\/eid2504.180202","article-title":"Seroprevalence of Borrelia burgdorferi, B. miyamotoi, and Powassan Virus in Residents Bitten by Ixodes Ticks, Maine, USA","volume":"25","author":"RP Smith","year":"2019","journal-title":"Emerging Infectious Diseases"},{"issue":"9","key":"pone.0289274.ref014","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1089\/vbz.2018.2421","article-title":"Geographic Range of Lyme Borreliosis in Mongolia.","volume":"19","author":"ME von Fricken","year":"2019","journal-title":"Borne and Zoonotic Diseases (Larchmont, N.Y.),"},{"issue":"11","key":"pone.0289274.ref015","doi-asserted-by":"crossref","first-page":"3557","DOI":"10.1007\/s00436-018-6053-x","article-title":"Some aspects on tick species in Mongolia and their potential role in the transmission of equine piroplasms, Anaplasma phagocytophilum and Borrelia burgdorferi L","volume":"117","author":"M Narankhajid","year":"2018","journal-title":"Parasitology Research"},{"issue":"1","key":"pone.0289274.ref016","doi-asserted-by":"crossref","first-page":"1450591","DOI":"10.1080\/20008686.2018.1450591","article-title":"A cross-sectional study of small mammals for tick-borne pathogen infection in northern Mongolia","volume":"8","author":"LA Pulscher","year":"2018","journal-title":"Infection Ecology & Epidemiology"},{"key":"pone.0289274.ref017","doi-asserted-by":"crossref","first-page":"100680","DOI":"10.1016\/j.vprsr.2021.100680","article-title":"Distribution and prevalence of Taenia hydatigena, Taenia multiceps, and Mesocestoides spp.","volume":"28","author":"J Temuujin","year":"2022","journal-title":"In Mongolian sheepdogs. Veterinary Parasitology, Regional Studies and Reports"},{"key":"pone.0289274.ref018","volume-title":"R: A language and environment for statistical computing","author":"RC Team","year":"2016"},{"issue":"4","key":"pone.0289274.ref019","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1086\/514009","article-title":"Duration of tick attachment as a predictor of the risk of Lyme disease in an area in which Lyme disease is endemic","volume":"175","author":"SK Sood","year":"1997","journal-title":"The Journal of Infectious Diseases"},{"issue":"2","key":"pone.0289274.ref020","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1056\/NEJM200107123450201","article-title":"Tick Bite Study Group. Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite","volume":"345","author":"RB Nadelman","year":"2001","journal-title":"The New England Journal of Medicine"},{"key":"pone.0289274.ref021","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s11125-008-9079-5","article-title":"Quality and equity in the Mongolian education sector.","volume":"38","author":"G Steiner-Khamsi","year":"2008","journal-title":"Prospects"},{"key":"pone.0289274.ref022","doi-asserted-by":"crossref","DOI":"10.1057\/9781403982971","volume-title":"Educational import: Local encounters with global forces in Mongolia","author":"G Steiner-Khamsi","year":"2006"},{"key":"pone.0289274.ref023","doi-asserted-by":"crossref","first-page":"342","DOI":"10.4269\/ajtmh.2007.77.342","article-title":"Taeniasis in Mongolia, 2002\u20132006.","volume":"77","author":"2","year":"2007","journal-title":"The American Journal of Tropical Medicine and Hygiene"},{"key":"pone.0289274.ref024","author":"World Health Organization","year":"2011","journal-title":"Health of adolescents in Mongolia"},{"issue":"20","key":"pone.0289274.ref025","doi-asserted-by":"crossref","first-page":"3892","DOI":"10.3390\/ijerph16203892","article-title":"Inequalities in Caries Experience Among Mongolian Children.","volume":"16","author":"T Chinzorig","year":"2019","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"2","key":"pone.0289274.ref026","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1002\/rmv.566","article-title":"Socio-economic factors in the differential upsurge of tick-borne encephalitis in Central and Eastern Europe","volume":"18","author":"D Sumilo","year":"2008","journal-title":"Reviews in Medical Virology"},{"key":"pone.0289274.ref027","article-title":"Study on public perceptions and protective behaviors regarding Lyme disease among the general public in the Netherlands: Implications for prevention programs.","volume":"13","author":"DJMA Beaujean","year":"2013","journal-title":"BMC Public Health"},{"key":"pone.0289274.ref028","unstructured":"Asian Development Bank. (n.d.). Mongolia: Health and Social Protection. Rapid Sector Assessment October 2008. https:\/\/www.oecd.org\/countries\/mongolia\/42227662.pdf."},{"issue":"1","key":"pone.0289274.ref029","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1080\/22221751.2022.2065930","article-title":"Mapping the risk distribution of Borrelia burgdorferi sensu lato in China from 1986 to 2020: A geospatial modelling analysis.","volume":"11","author":"TL Che","year":"2022","journal-title":"Emerging Microbes & Infections,"},{"issue":"1\u20132","key":"pone.0289274.ref030","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.vetpar.2004.05.027","article-title":"Incidence and prevalence of tick-borne haemoparasites in domestic ruminants in Ghana","volume":"124","author":"L Bell-Sakyi","year":"2004","journal-title":"Veterinary Parasitology"},{"issue":"1","key":"pone.0289274.ref031","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1186\/s13071-019-3699-x","article-title":"Molecular identification and prevalence of tick-borne pathogens in zebu and taurine cattle in North Cameroon.","volume":"12","author":"B Abanda","year":"2019","journal-title":"Parasites & Vectors"},{"issue":"4","key":"pone.0289274.ref032","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1080\/00034983.1971.11686782","article-title":"Finding of tick-borne relapsing fever in Jordan by the Malaria Eradication Service","volume":"65","author":"J De Zulueta","year":"1971","journal-title":"Annals of Tropical Medicine and Parasitology"},{"issue":"4","key":"pone.0289274.ref033","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.ttbdis.2012.04.001","article-title":"Rickettsia raoultii, the predominant Rickettsia found in Mongolian Dermacentor nuttalli.","volume":"3","author":"S Speck","year":"2012","journal-title":"Ticks and Tick-Borne Diseases"},{"issue":"9391","key":"pone.0289274.ref034","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/S0140-6736(03)14515-1","article-title":"Rickettsia sibirica infection in members of scientific expeditions to northern Asia","volume":"362","author":"MR Lewin","year":"2003","journal-title":"Lancet (London, England),"},{"key":"pone.0289274.ref035","first-page":"006","article-title":"Detection and epidemiology of tick-borne pathogens in free-ranging livestock in Mongolia","volume":"S3","author":"S Papageorgiou","year":"2012","journal-title":"Journal of Clinical & Experimental Pathology"},{"key":"pone.0289274.ref036","volume-title":"Surveillance and Epidemiology of Tick-borne Pathogens in Mongolian Ungulates","author":"S. Papageorgiou","year":"2011"},{"issue":"1","key":"pone.0289274.ref037","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/nrdp.2016.90","article-title":"Lyme borreliosis.","volume":"2","author":"AC Steere","year":"2016","journal-title":"Nature reviews Disease primers"},{"issue":"3","key":"pone.0289274.ref038","doi-asserted-by":"crossref","first-page":"569","DOI":"10.7589\/0090-3558-44.3.569","article-title":"A novel clinical syndrome and detection of Anaplasma ovis in Mongolian reindeer (Rangifer tarandus).","volume":"44","author":"JC Haigh","year":"2008","journal-title":"Journal of Wildlife Diseases"},{"key":"pone.0289274.ref039","doi-asserted-by":"crossref","first-page":"100458","DOI":"10.1016\/j.onehlt.2022.100458","article-title":"Knowledge of Mongolian veterinarians towards canine vector-borne diseases.","volume":"15","author":"C Davitt","year":"2022","journal-title":"One Health."},{"issue":"3","key":"pone.0289274.ref040","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s11262-012-0795-9","article-title":"Isolation, preliminary characterization, and full-genome analyses of tick-borne encephalitis virus from Mongolia","volume":"45","author":"S Frey","year":"2012","journal-title":"Virus Genes"},{"issue":"5","key":"pone.0289274.ref041","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.ttbdis.2015.05.006","article-title":"Isolation and characterization of tick-borne encephalitis virus from Ixodes persulcatus in Mongolia in 2012.","volume":"6","author":"M Muto","year":"2015","journal-title":"Ticks and Tick-Borne Diseases"},{"issue":"6","key":"pone.0289274.ref042","doi-asserted-by":"crossref","first-page":"101268","DOI":"10.1016\/j.ttbdis.2019.101268","article-title":"Hard ticks and tick-borne pathogens in Mongolia-A review.","volume":"10","author":"J \u010cern\u00fd","year":"2019","journal-title":"Ticks and Tick-Borne Diseases,"},{"key":"pone.0289274.ref043","first-page":"90","article-title":"Fauna and ecology of ixodid ticks in Mongolia","volume":"3","author":"G Danchinova","year":"2007","journal-title":"Acta Biomed Sci East Sib Biomed J"},{"key":"pone.0289274.ref044","doi-asserted-by":"crossref","first-page":"946631","DOI":"10.3389\/fmicb.2022.946631","article-title":"Metagenomic profiles of Dermacentor tick pathogens from across Mongolia, using next generation sequencing","volume":"13","author":"D Altantogtokh","year":"2022","journal-title":"Frontiers in Microbiology"},{"issue":"1","key":"pone.0289274.ref045","doi-asserted-by":"crossref","first-page":"47","DOI":"10.7883\/yoken.67.47","article-title":"PCR detection of Anaplasma phagocytophilum and Borrelia burgdorferi in Ixodes persulcatus ticks in Mongolia","volume":"67","author":"T Masuzawa","year":"2014","journal-title":"Japanese Journal of Infectious Diseases"},{"issue":"1","key":"pone.0289274.ref046","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.vetpar.2004.08.021","article-title":"Epidemiological study of equine piroplasmosis in Mongolia","volume":"127","author":"D Boldbaatar","year":"2005","journal-title":"Veterinary Parasitology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0289274","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T17:29:47Z","timestamp":1691515787000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0289274"}},"subtitle":[],"editor":[{"given":"Joshua","family":"Kamani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,8,8]]},"references-count":46,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0289274","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,8]]}}}