Tick spotting: using mannequins to evaluate individual efficacy at detecting Ixodes scapularis (Acari: Ixodidae).

Tick checks are a free and accessible personal protection measure used to prevent tick bites and are frequently recommended by public health institutions and vector-borne disease researchers. However, little is known about how successful people are at detecting ticks on themselves or others when using this method. We developed a tool for evaluating factors affecting the efficacy of tick checks using mannequins. In 2022 and 2023, we recruited 207 participants to complete a brief survey and perform a tick check on a mannequin, where dead Ixodes scapularis Say larvae, nymphs, and adults had been glued at various locations. None of the survey results (demographics, knowledge, attitude, and concerns about ticks and tick-borne disease) were associated with likelihood of tick detection. On average, participants detected 42% of nymphs on the mannequin. Adult females were 3 to 4 times more likely to be detected than nymphs. Ticks above the waistline were detected 3 times more frequently than ticks below. Ticks that were on white-colored clothing were 3 times more likely to be detected than those on dark-colored clothing. Ticks that were not covered by hair or clothing were 2 times more likely to be detected than covered ticks. These findings show that there are multiple factors that may limit tick detection during a tick check. Outreach should emphasize the importance of awareness of size variation between stages, completing a thorough whole-body examination including the lower limbs and covered locations, and wearing light-colored clothing.