Human tick biting and tick-borne disease risk in Türkiye: Systematic review.

Abstract

Ticks serve as significant vectors for over 100 pathogens, many of which pose serious health risks to humans. Türkiye's diverse tick species and ideal ecological conditions facilitate their proliferation. Following the emergence of the Crimean-Congo Hemorrhagic Fever (CCHF) epidemic in 2004, tick-borne diseases have become a critical public health concern. This systematic review was conducted to identify the dominant tick genera and species responsible for human bites and tick-borne diseases. PubMed, Cochrane, Scopus, Web of Science, Medline, Tübitak TR Dizin, Dergi Park databases were searched following PRISMA guidelines, and the last search was performed on 11 October 2024. Studies reporting human-biting ticks were included and studies that do not report tick species or number of ticks were excluded. A novel quality assessment scale was developed by Türkiye Infectious Diseases (TEH) Vector-Borne Infections Study Group and used for risk of bias assessment. The total number of ticks and percentages were calculated. A total of 24 studies documented 53,879 ticks, 96.60% of which were identified at the genus or species level. The most prevalent genera were Hyalomma (46.99%) and Ixodes (28.49%), followed by Rhipicephalus and Haemaphysalis. Notably, immature forms of Hyalomma spp., particularly nymphs, accounted for the highest proportion of bites (22.65%). The findings highlight Hyalomma and Ixodes as primary vectors for major diseases in Türkiye, with H. marginatum playing a central role in seasonal outbreaks of CCHF in rural Anatolia and Ixodes spp. linked to Lyme disease. Türkiye's geographic and climatic diversity, along with factors such as migratory bird routes, facilitates the distribution of ticks and the emergence of novel tick-borne diseases. Despite the notable risks, inconsistent tick identification and reporting impede accurate assessment and management. Standardized methodologies and comprehensive reporting systems are strongly recommended to better address the public health risks posed by tick-borne diseases.