Geebelen Laurence, Lernout Tinne, Kabamba-Mukadi Benoît, Saegeman Veroniek, Sprong Hein, Van Gucht Steven, Beutels Philippe, Speybroeck Niko, Tersago Katrien
Epidemiology of Infectious Diseases, Scientific Institute of Public Health (WIV-ISP), Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
Laboratory of Medical Microbiology, Université Catholique de Louvain (UCL), Brussels, Belgium.
Arch Public Health. 2017 Aug 7;75:42. doi: 10.1186/s13690-017-0202-z. eCollection 2017.
In Belgium, different routine surveillance systems are in place to follow-up Lyme borreliosis trends. However, accurate data on the disease and monetary burden for the different clinical manifestations are lacking. Despite recommended antibiotic treatment, a proportion of Lyme patients report persisting aspecific symptoms for six months or more (e.g. fatigue, widespread musculoskeletal pain, cognitive difficulties), a syndrome now named "post-treatment Lyme disease syndrome" (PTLDS). Controversy exists on the cause, incidence and severity of PTLDS. This study aims to estimate the incidence of PTLDS in patients with Lyme borreliosis and to quantify the disease burden and economic costs associated with the different clinical manifestations of Lyme borreliosis in Belgium.
The project is a prospective cohort study in which about 600 patients with an erythema migrans and 100 patients with disseminated Lyme borreliosis will be followed up. Questionnaires, including the SF-36 vitality and pain subscale, the Cognitive Failure Questionnaire and the EQ-5D-5L, will be used to collect information on acute and persisting symptoms and the impact on quality of life. Symptom frequency and severity will be compared with self-reported pre-Lyme health status, a control group and existing Belgian population norms. Additionally, information on the associated costs and possible risk factors for the development of PTLDS will be collected.
A study of the health burden will allow evaluation of the relative importance of Lyme borreliosis in Belgium and information on the economic cost will help to formulate cost-effective measures. There are only few prospective studies conducted estimating the incidence of PTLDS and even though discussion exists about the prevalence of subjective symptoms in the general population, a control group of non-Lyme borreliosis participants has often not been included.
在比利时，有不同的常规监测系统来跟踪莱姆病的发病趋势。然而，缺乏关于该疾病以及不同临床表现的经济负担的准确数据。尽管有推荐的抗生素治疗方法，但仍有一部分莱姆病患者报告持续出现非特异性症状达六个月或更长时间（例如疲劳、广泛的肌肉骨骼疼痛、认知困难），这种综合征现在被称为“治疗后莱姆病综合征”（PTLDS）。关于PTLDS的病因、发病率和严重程度存在争议。本研究旨在估计莱姆病患者中PTLDS的发病率，并量化与比利时莱姆病不同临床表现相关的疾病负担和经济成本。
该项目是一项前瞻性队列研究，将对约600例游走性红斑患者和100例播散性莱姆病患者进行随访。将使用问卷，包括SF-36活力和疼痛子量表、认知功能障碍问卷和EQ-5D-5L，来收集有关急性和持续症状以及对生活质量影响的信息。症状的频率和严重程度将与自我报告的莱姆病前健康状况、一个对照组以及比利时现有的人群标准进行比较。此外，还将收集有关相关成本以及PTLDS发生的可能风险因素的信息。
对健康负担的研究将有助于评估莱姆病在比利时的相对重要性，而有关经济成本的信息将有助于制定具有成本效益的措施。目前仅有少数前瞻性研究估计PTLDS的发病率，而且尽管对于一般人群中主观症状的患病率存在讨论，但通常并未纳入非莱姆病参与者的对照组。
