School Intervention for Vector-Borne Diseases in Maine: Educating Fifth Graders on Tick- and Mosquito-Borne Diseases and Prevention Methods

BACKGROUND:  Children ages 5-14 years are a high-risk cohort for contracting tick- and mosquito-borne illnesses. The Public Health Education Corps (PHEC) within Maine Center for Disease Control and Prevention (CDC) prepared an educational pilot program for fifth grade students on tick- and mosquito-borne diseases and prevention methods. The program was split into two units, ticks and mosquitoes. Based on prevalence of vector-borne disease activity in recent years and interest in participation, PHEC selected two schools to participate in the pilot program. Alfred Elementary School in York County represented the high-incidence area of vector-borne activity and Durham Community School in Androscoggin County represented the low-incidence area. PHEC hypothesized that the students in Alfred would have a larger knowledge-base about ticks and mosquitoes as they lived in a high-incidence area for Lyme disease prevalence, and recently had mosquito pools identified as positive for Eastern Equine Encephalitis (EEE) virus. 

METHODS:  PHEC collaborated with an epidemiologist and two biologists to develop the program, which included: pre and post-tests to measure content knowledge before and after the intervention; PowerPoint presentations of tick and mosquito biology and illnesses; hands-on activities to identify habitats of ticks and mosquitoes, disease prevention methods, and disease symptom identification; activity booklets reinforcing information learned in the presentations and activities; and take-home fact sheets.

RESULTS:  Tick and mosquito pre- and post-test scores revealed an improvement in content knowledge at both schools. The most significant improvements were in knowledge of tick identification, diseases carried by mosquitoes, and bite prevention methods. Alfred students demonstrated 64% improvement on the post-test for identifying a deer tick picture, while Durham students demonstrated a 17% improvement. Students at both schools did similarly well on the mosquito pre- and post-tests.

CONCLUSIONS:  Contrary to the hypothesis, the pre- and post-test scores did not indicate a significantly higher knowledge-base of ticks and mosquitoes for students in Alfred. Logistical differences in presentations may have impacted the variation of improvement in the post-test result as the number of students, length of the presentation, and location of the intervention differed at each school. Participants from both schools demonstrated an improvement in their ability to identify the symptoms of tick- and mosquito-borne diseases, recognize recommended prevention methods, identify a deer tick, and recommend tick and mosquito reduction opportunities around their homes. The results lead us to conclude that no matter the prevalence of disease in a geographic area, vector-borne education is needed with this cohort.