How threat perception of tick-borne diseases shapes preventive and control measures among dog owners in Iquitos, Peru

Abstract Knowledge, attitudes, and practices (KAP) studies help identify priority groups for control interventions. They include multiple factors, such as threat perception—encompassing perceived susceptibility and severity of a health risk—and sociodemographic data, which have been shown to be associated with individual prevention and control measures for mosquito-borne diseases. However, their application to tick-borne diseases (TBDs) remains largely unstudied in limited-resource settings. Ehrlichia canis , transmitted by Rhipicephalus sanguineus s.l. ticks, is highly prevalent in Iquitos, Peru, a city in the Peruvian Amazon. We analyzed data from a questionnaire completed by 285 dog owners in Iquitos to assess whether the perceived threat from ticks and TBDs is linked to preventive measures for homes and dogs. Secondary aims included examining the associations between TBD awareness and preventive/control measures, as well as identifying sociodemographic factors linked to these measures and threat perception. We used simple and multiple regression models to evaluate the associations of interest. We found that 31.6% of participants (n = 90) were unaware that TBDs could occur in humans. This group tended to be older, with lower education levels and lower income. Only a small portion of the included participants reported using preventive/control measures. After adjusting for sociodemographic factors, TBD awareness was associated with a higher likelihood of home spraying. Furthermore, those who perceived TBDs as moderate diseases were marginally more likely to apply spray acaricide to their dogs, while those who perceived these diseases as severe to very severe were more likely to administer oral acaricides to their dogs. These findings highlight variability in the link between threat perception and preventive measures. Results suggest TBD awareness campaigns may benefit from focusing on older individuals with lower education and income, while educational efforts promoting effective prevention measures like acaricidal pills should target all dog owners. Author summary In Iquitos, Peru, the high prevalence of Rhipicephalus sanguineus s.l. infestation in dogs and homes and the high prevalence of Ehrlichia canis infection in dogs, highlight the need for urgent tick prevention and control. Understanding the influence of awareness, attitudes (including perceived threat) and sociodemographic factors on practices is key to designing effective interventions and identifying target groups. We analyzed data from 285 dog owners to assess if perceived threat (susceptibility and severity) from ticks and tick-borne diseases (TBDs) was linked to self-reported preventive measures for homes and dogs. We also examined TBD awareness and sociodemographic factors potentially associated with preventive practices. Among participants, 31.6% were unaware that TBDs could affect humans, with this group tending to be older and have lower education and income levels. Perceived susceptibility to tick bites and TBDs was not linked to preventive measures, while perceiving TBDs as moderate to severe increased the likelihood of using spray and oral acaricides on dogs. However, usage remained low even among those with high perceived severity. These findings reveal varied associations between threat perception and preventive practices, as they may be influenced by factors such as perceived benefits, barriers, and self-efficacy. Educational efforts should target older adults, and those with lower education and income, while campaigns promoting effective measures like acaricidal pills should address all dog owners.