Gordon Brestrich , Christine Hagemann , Joanna Diesing , Nils Kossack , James H. Stark , Andreas Pilz , Frederick J. Angulo , Holly Yu , Jochen Suess
{"title":"德国莱姆病发病率:一项回顾性医疗索赔观察研究","authors":"Gordon Brestrich , Christine Hagemann , Joanna Diesing , Nils Kossack , James H. Stark , Andreas Pilz , Frederick J. Angulo , Holly Yu , Jochen Suess","doi":"10.1016/j.ttbdis.2024.102326","DOIUrl":null,"url":null,"abstract":"<div><p>Lyme borreliosis (LB) is the most common tick–borne disease in Germany. Although the incidence of LB in Germany has been assessed in several studies, those studies either used data from statutory surveillance, which frequently underreport cases, or data from health claims databases, which may overestimate cases due to non–specific LB case definitions. Here, using a more specific case definition, we describe the incidence of medically–attended LB by disease manifestation, age group, and federal state for the period 2015–2019. Both inpatient and outpatient cases were analyzed from a claims database. To be eligible for inclusion, patients were required to have an LB specific ICD–10 GM diagnosis code plus an antibiotic prescription, and for disseminated manifestations, a laboratory test order additionally. LB cases were classified as erythema migrans (EM), or disseminated disease including Lyme arthritis (LA), Lyme neuroborreliosis (LNB), and all other disease manifestations (OTH). Between 2015 and 2019, the incidence of medically–attended LB cases ranged from 195.7/100,000 population per year (95% confidence interval [CI], 191.0 – 200.5) to 254.5/100,000 population per year (95% CI, 249.0 – 260.0) per year. The majority of cases (92.2%) were EM, while 2.8% presented as LA, 3.8% as LNB, and 1.2% as OTH. For both EM and disseminated disease, the incidence peaked in children aged 5–9 years and in older adults. By federal state, the incidence of medically–attended EM ranged from 74.4/100,000 population per year (95% CI, 71.9 – 77.0) per year in Hamburg, to 394.1/100,000 population per year (95% CI, 370.7 – 417.6) per year in Saxony, whereas for medically–attended disseminated disease, the highest incidence was in Thuringia, Saxony, and Bavaria (range: 22.0 [95% CI, 19.9 – 24.0] to 35.7 [95% CI, 34.7 – 36.7] per 100,000 population per year). This study comprehensively estimated the incidence of all manifestations of medically–attended LB and showed a high incidence of LB throughout Germany. Results from the study support performing epidemiological studies in all federal states to measure the burden of LB and to invest in public health interventions for prevention.</p></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"15 3","pages":"Article 102326"},"PeriodicalIF":3.1000,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877959X24000190/pdfft?md5=29de3bf09242fed1e6ab649b2395e60e&pid=1-s2.0-S1877959X24000190-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Incidence of Lyme Borreliosis in Germany: A retrospective observational healthcare claims study\",\"authors\":\"Gordon Brestrich , Christine Hagemann , Joanna Diesing , Nils Kossack , James H. Stark , Andreas Pilz , Frederick J. Angulo , Holly Yu , Jochen Suess\",\"doi\":\"10.1016/j.ttbdis.2024.102326\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Lyme borreliosis (LB) is the most common tick–borne disease in Germany. Although the incidence of LB in Germany has been assessed in several studies, those studies either used data from statutory surveillance, which frequently underreport cases, or data from health claims databases, which may overestimate cases due to non–specific LB case definitions. Here, using a more specific case definition, we describe the incidence of medically–attended LB by disease manifestation, age group, and federal state for the period 2015–2019. Both inpatient and outpatient cases were analyzed from a claims database. To be eligible for inclusion, patients were required to have an LB specific ICD–10 GM diagnosis code plus an antibiotic prescription, and for disseminated manifestations, a laboratory test order additionally. LB cases were classified as erythema migrans (EM), or disseminated disease including Lyme arthritis (LA), Lyme neuroborreliosis (LNB), and all other disease manifestations (OTH). Between 2015 and 2019, the incidence of medically–attended LB cases ranged from 195.7/100,000 population per year (95% confidence interval [CI], 191.0 – 200.5) to 254.5/100,000 population per year (95% CI, 249.0 – 260.0) per year. The majority of cases (92.2%) were EM, while 2.8% presented as LA, 3.8% as LNB, and 1.2% as OTH. For both EM and disseminated disease, the incidence peaked in children aged 5–9 years and in older adults. By federal state, the incidence of medically–attended EM ranged from 74.4/100,000 population per year (95% CI, 71.9 – 77.0) per year in Hamburg, to 394.1/100,000 population per year (95% CI, 370.7 – 417.6) per year in Saxony, whereas for medically–attended disseminated disease, the highest incidence was in Thuringia, Saxony, and Bavaria (range: 22.0 [95% CI, 19.9 – 24.0] to 35.7 [95% CI, 34.7 – 36.7] per 100,000 population per year). This study comprehensively estimated the incidence of all manifestations of medically–attended LB and showed a high incidence of LB throughout Germany. Results from the study support performing epidemiological studies in all federal states to measure the burden of LB and to invest in public health interventions for prevention.</p></div>\",\"PeriodicalId\":49320,\"journal\":{\"name\":\"Ticks and Tick-borne Diseases\",\"volume\":\"15 3\",\"pages\":\"Article 102326\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2024-02-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1877959X24000190/pdfft?md5=29de3bf09242fed1e6ab649b2395e60e&pid=1-s2.0-S1877959X24000190-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ticks and Tick-borne Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1877959X24000190\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ticks and Tick-borne Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1877959X24000190","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Incidence of Lyme Borreliosis in Germany: A retrospective observational healthcare claims study
Lyme borreliosis (LB) is the most common tick–borne disease in Germany. Although the incidence of LB in Germany has been assessed in several studies, those studies either used data from statutory surveillance, which frequently underreport cases, or data from health claims databases, which may overestimate cases due to non–specific LB case definitions. Here, using a more specific case definition, we describe the incidence of medically–attended LB by disease manifestation, age group, and federal state for the period 2015–2019. Both inpatient and outpatient cases were analyzed from a claims database. To be eligible for inclusion, patients were required to have an LB specific ICD–10 GM diagnosis code plus an antibiotic prescription, and for disseminated manifestations, a laboratory test order additionally. LB cases were classified as erythema migrans (EM), or disseminated disease including Lyme arthritis (LA), Lyme neuroborreliosis (LNB), and all other disease manifestations (OTH). Between 2015 and 2019, the incidence of medically–attended LB cases ranged from 195.7/100,000 population per year (95% confidence interval [CI], 191.0 – 200.5) to 254.5/100,000 population per year (95% CI, 249.0 – 260.0) per year. The majority of cases (92.2%) were EM, while 2.8% presented as LA, 3.8% as LNB, and 1.2% as OTH. For both EM and disseminated disease, the incidence peaked in children aged 5–9 years and in older adults. By federal state, the incidence of medically–attended EM ranged from 74.4/100,000 population per year (95% CI, 71.9 – 77.0) per year in Hamburg, to 394.1/100,000 population per year (95% CI, 370.7 – 417.6) per year in Saxony, whereas for medically–attended disseminated disease, the highest incidence was in Thuringia, Saxony, and Bavaria (range: 22.0 [95% CI, 19.9 – 24.0] to 35.7 [95% CI, 34.7 – 36.7] per 100,000 population per year). This study comprehensively estimated the incidence of all manifestations of medically–attended LB and showed a high incidence of LB throughout Germany. Results from the study support performing epidemiological studies in all federal states to measure the burden of LB and to invest in public health interventions for prevention.
期刊介绍:
Ticks and Tick-borne Diseases is an international, peer-reviewed scientific journal. It publishes original research papers, short communications, state-of-the-art mini-reviews, letters to the editor, clinical-case studies, announcements of pertinent international meetings, and editorials.
The journal covers a broad spectrum and brings together various disciplines, for example, zoology, microbiology, molecular biology, genetics, mathematical modelling, veterinary and human medicine. Multidisciplinary approaches and the use of conventional and novel methods/methodologies (in the field and in the laboratory) are crucial for deeper understanding of the natural processes and human behaviour/activities that result in human or animal diseases and in economic effects of ticks and tick-borne pathogens. Such understanding is essential for management of tick populations and tick-borne diseases in an effective and environmentally acceptable manner.