Vázquez-López María Esther, Fernández Gonzalo, Díaz Pablo, Díez-Morrondo Carolina, Pego-Reigosa Robustiano, Coira-Nieto Amparo
Servicio de Pediatría, Hospital Universitario Lucus Agusti, Lugo, España.
Unidad de Epidemiología, Zoonosis y Salud Pública, Facultad de Veterinaria, Universidad de Santiago de Compostela, Lugo, España.
Aten Primaria. 2018 Jan;50(1):16-22. doi: 10.1016/j.aprim.2017.01.008. Epub 2017 May 2.
The main aim of this study was to determine the usefulness of an early diagnosis of Lyme disease (LD) in Primary Health Care Centres (PHCC) using the ELISA test as serological screening technique.
A retrospective study (2006-2013) was performed in order to determine the anti-Borrelia seropositivity in 2,842 people at risk of having LD. The possible relationship between the environment and the area of residence with anti-Borrelia seropositivity was also studied according to the origin of the specimens (PHCC/Hospital).
Overall, 15.2% of samples were positive to Borrelia spp. Seropositivity was significantly higher in samples sent by PHCC doctors than those sent by Hospital doctors. Seropositivity was significantly higher in rural than in urban populations and in those who live in mountainous or flat areas. The percentage of seropositivity has increased over the years.
The role of the PHCC doctor is essential for achieving an early diagnosis of Lyme disease, as a higher percentage of seropositives was detected in samples submitted from PHCC. Furthermore, most early localised LD patients were diagnosed in PHCC, avoiding the appearance of sequelae. Therefore, detection of Borrelia specific antibodies using an ELISA assay is a useful screening test for patients at risk of LD.
本研究的主要目的是确定在初级卫生保健中心(PHCC)使用酶联免疫吸附测定(ELISA)试验作为血清学筛查技术对莱姆病(LD)进行早期诊断的实用性。
进行了一项回顾性研究(2006 - 2013年),以确定2842名有患莱姆病风险的人的抗伯氏疏螺旋体血清阳性情况。还根据标本来源(PHCC/医院)研究了环境和居住区域与抗伯氏疏螺旋体血清阳性之间的可能关系。
总体而言,15.2%的样本对伯氏疏螺旋体属呈阳性。PHCC医生送检的样本血清阳性率显著高于医院医生送检的样本。农村人口的血清阳性率显著高于城市人口,且生活在山区或平原地区的人群血清阳性率也较高。多年来血清阳性率有所上升。
PHCC医生的作用对于实现莱姆病的早期诊断至关重要,因为从PHCC提交的样本中检测到的血清阳性率更高。此外,大多数早期局限性莱姆病患者在PHCC被诊断出来,避免了后遗症的出现。因此,使用ELISA检测伯氏疏螺旋体特异性抗体对有莱姆病风险的患者是一种有用的筛查试验。